Oral Answers to Questions

NORTHERN IRELAND

The Secretary of State was asked—

Police Service of Northern Ireland

Helen Jackson: If he will make a statement on recent reforms to the Police Service of Northern Ireland.

Jane Kennedy: I refer my hon. Friend to the statement that my right hon. Friend the Secretary of State for Northern Ireland made on 25 November. The Government remain committed to the new beginning to policing, building on the implementation of the recommendations of the independent commission on policing for Northern Ireland. Working with the police and the Policing Board, we continue to make steady progress across a range of areas.

Helen Jackson: Does the Minister agree that we now have a unique opportunity—while the Assembly is in recession, so to speak—to ensure that, through policing, we put in place the final, difficult ingredients? Is it not the case that any party that wants to play a constitutional role in the government of Northern Ireland must play a role in its civil police service, and must recognise that that is part of politics—

Mr. Speaker: Order. I think that the Minister gets the drift.

Jane Kennedy: I am grateful to my hon. Friend for making that point. The Government's aim is to develop a modern police service that is both effective and widely accepted throughout the society that it serves. As my right hon. Friend the Prime Minister said on 17 October, the concept of republicans being on the Policing Board while maintaining an active paramilitary organisation outside of the law is an absurdity.

Lembit �pik: Given the evident need for good, well-qualified police officers in Northern Ireland, of whatever religion, will the Minister please explain the consequences if a police recruit from one religious denomination or another pulls out during the qualification process? Is there any pressure for a reciprocal withdrawal to maintain the 50:50 ratio?

Jane Kennedy: The hon. Gentleman knows the detail of the arrangements that bring into effect the 50:50 recruitment of Catholics and Protestants to the Northern Ireland police service. He also understands that our efforts are directed towards achieving a more accountable, representative and effective police force. It is worth noting that 35 per cent. of those applying to join PSNI over the last year have come from the Catholic community. I look forward to that trend continuing over the coming years.

Seamus Mallon: I know that the Minister is convinced that policing is a crucial part of the creation of peace and political stability in Northern Ireland. I note with more than a little pleasure that 14 of the amendments that have been made will be instantly recognised by those who sat on the last police Bill Committee. Will she give an assurance that, this time, nobody will be allowed to play political games with the very important issue of policing, and that no party or Government will be allowed to use it as a bargaining chip for political reasons?

Jane Kennedy: The forthcoming Bill will cover the commitments, to which the hon. Gentleman refers, to legislative change that we made in the updated Patten implementation plan that we published in August last year, and other issues that have arisen during the review.

Lady Hermon: Given that the Patten report specifically warned against the balkanisation of policing in Northern Ireland, can the Minister assure me that the new policing proposals announced this week will not lead to any such balkanisation?

Jane Kennedy: The hon. Lady knows that we are in the early stages of discussing the detail of the Bill. Her specific point would not be any part of our intention in developing the new proposals surrounding the accountability of policing in Northern Ireland. We will debate the detail as we proceed through the parliamentary stages of the Bill, and I hope that we can thrash out all those details in debate in time-honoured fashion.

Gregory Campbell: Does the Minister accept that further concessions on policing, such as permitting terrorists to sit on district policing partnerships, will be viewed across the community in Northern Ireland, in Unionist and nationalist areas, as totally unacceptable?

Jane Kennedy: The clauses that we have published, which we hope will form part of the Bill, give effect to the commitments that we made at the Weston Park talks last year. Those commitments, once enacted, will fully reflect the Patten recommendations. Had the Government contemplated further concessions, however, they would have been included in those clauses.

John Taylor: As a precondition of convicted terrorists sitting as independent members of district policing partnerships, the Secretary of State has said that there must be Xacts of completion by the IRA. Will the Minister confirm that these Xacts of completion must include decommissioning and, crucially, disbandment?

Jane Kennedy: We gave a commitment to consider in the context of the policing review the disqualification rules for membership of DPPs and, indeed, the powers of the Belfast DPP sub-groups to which the hon. Member for North Down (Lady Hermon) referred. However, we are not yet persuaded that the time is right to introduce changes in these areas, so they will not be included in the Bill. It is our view that the removal of the disqualification of ex-prisoners could happen only in the context of acts of completion as envisaged by my right hon. Friend the Prime Minister in his speech in Belfast last month. I could not improve on his words.

Northern Ireland Assembly

Simon Hughes: What the preconditions are for the ending of the suspension of the Northern Ireland Assembly; and if he will make a statement.

Paul Murphy: The devolved institutions can operate only if there is trust that all parties to the Belfast agreement are committed to fulfilling their obligations, including the commitment to exclusively democratic and peaceful means. Rebuilding trust was a key focus of the talks at Parliament buildings last Thursday. We are urgently seeking with the Irish Government and the parties in Northern Ireland the basis on which that trust can be restored.

Simon Hughes: The House will accept entirely the premise that the Secretary of State set out. Does he agree that it would therefore be timely for the Government to initiate in this context a complete review of the Good Friday agreement as provided for under paragraph 8 of the agreement? Does he accept that, to see a good way forward, one has to predict all the foreseeable difficulties, and they must include how Members of the Northern Ireland Assembly are designated? That was a major stumbling block a year ago.

Paul Murphy: As the hon. Gentleman knows, we will conduct the review under paragraph 7 of the agreement. That review gives all parties in the Assemblythose that choose to turn up to the meetings in Parliament buildings, such as the one that we held last week and that we will hold tomorrowthe opportunity to put their cards on the table and to make the points that they want to make.
	The hon. Gentleman referred specifically to designation. He will know that his colleagues in the Alliance party raised this issue last week. Of course, it is important that all of us get round the table, talk about the issues and resolve the current impasse.

John Hume: Given that for the first time in history the people of Ireland, north and south, have overwhelmingly, by voting for the agreement, stated how they wish to live together, it is therefore the duty of all true democrats to implement the will of the people. That sends a message to certain people on both sides. It sends a message to the paramilitaries such as the IRA, which since its foundation has always said that it is acting in the name of the Irish people. If it is now truly acting in the name of the Irish people, it should not only cease the violence but cease its existence as an organisation. It also sends a message to certain people

Mr. Speaker: Order. It is a supplementary question. I cannot allow the hon. Gentleman to continue. [Interruption.] Order. The hon. Gentleman must sit down. Will the Secretary of State reply?

Paul Murphy: My hon. Friend is right in terms of the fact that the people of Ireland, north and south, agreed to the Belfast agreement in a referendum after the Good Friday agreement was signed. Some 90 per cent. of the people of the island of Ireland and 70 per cent. of the people of Northern Ireland agreed with it. That meansI am sure that he agrees with thisthat there is an onus on everyone in Northern Ireland to understand that the only way that we can achieve progress is to do what the people of Ireland have voted upon.

David Trimble: In recalling the circumstances that led to the suspension, I am sure that the Secretary of State has seen the statement by the police in Northern Ireland that the criminal conspiracy that they uncovered went to the very heart of the republican movement. Their inquiries are continuing. In the light of that, would it not be wise to wait until we have seen the full extent of that conspiracy and who was involved in it? Should we therefore not wait until the inquiries have been completed? While doing that, would it not also be wise to have a thorough public inquiry into how the Northern Ireland Office conducted itself while the spy ring was operating in its own offices?

Paul Murphy: The right hon. Gentleman is aware that a thorough investigation is being undertaken by the security services as to why these events took place. He is also right to remind the House that this series of events finally led to the loss of confidence and trust between the parties in Stormont and to the suspension of the Assembly. It is important to discuss these issues in the political context. I am sure that that will happen tomorrow; it certainly happened last week.

Kevin McNamara: Will my right hon. Friend confirm that if it is not possible for the Assembly to be reinstated immediately or in the near future, the proposed elections to it will go ahead next year as planned?

Paul Murphy: We have no plans to change the dates of the elections to the Northern Ireland Assembly, set for 1 May next year. I sincerely hope, as I am sure every hon. Member does, that we resolve the difficulties before then.

Quentin Davies: Does the right hon. Gentleman's less than precise first answer to the questionI am putting it kindlymean that the completion of decommissioning and disbandment will be a precondition for Sinn Fein resuming its place in a revived power-sharing Executive?

Paul Murphy: The hon. Gentleman is right in saying that that is a precondition in the sense that, as my right hon. Friend the Prime Minister said, republicans
	Xmust make the commitment to exclusively peaceful means, real, total and permanent.
	My right hon. Friend went on to say:
	XWe cannot carry on with the IRA half in and half out of this process.
	That is clear to me. Those issues will be discussed at the beginning of the meeting tomorrow in Belfast and doubtless they will be at the heart of discussions in meetings to come.

Quentin Davies: I am grateful for the clear assurance at the beginning of that answer. It is enormously important. To put minds at rest in Northern Ireland and elsewhere, will the right hon. Gentleman give another assurance? He has made it clear in his handling of the police Bill that he has gone some way to understanding the error of unilateral concessions and the importance of linkage and of enforcing compliance. Will he therefore deny the rumour in the Northern Ireland press yesterday that the Government are again contemplating an amnesty for on-the-run terrorists?

Paul Murphy: The hon. Gentleman knows that those issues were discussed at Weston Park. We all know that those issues are particularly painful to victims in Northern Ireland on both sides of the community. I repeat what I said: as my right hon. Friend the Prime Minister made clear, the Government will only contemplate steps on all issues, including the ones to which the hon. Gentleman referred, in the context of acts of completion.

Huw Irranca-Davies: Despite the tortuous nature of current negotiations on police reform and the peace process, will my right hon. Friend commend the words and actions of all those politicians who are working towards peace? Will he also commend the words of Martin Luther King:
	XPeace is not merely a distant goal . . . but a means by which we arrive at that goal?

Paul Murphy: Of course I echo my hon. Friend's eloquent comments. When I recently took on this job after an absence of three years, I was struck by the fact that the streets of Belfast and Northern Ireland are still very peaceful by comparison with the situation a decade ago. We cannot take for granted the progress that has been made, but we understand that much still needs to be done.

Irish Fertilizer Industries

Vincent Cable: If he will make a statement on the employment impact of the closure of Irish Fertilizer Industries' factory in north Belfast.

Ian Pearson: The loss of 207 jobs and some 11 million to the local economy has obviously had a devastating effect on employees and their families. I have asked Invest Northern Ireland to work with the liquidator to try to identify an investor for the Belfast factory, and the Department for Employment and Learning is advising the work force on employment and training opportunities and on social security matters.

Vincent Cable: Is the Minister aware of the problem arising from the fact that the workers have lost not just their jobs, but 60 per cent. of their pensions because the ownersthe Irish Government and ICIchronically underfunded the pension scheme? Will he and his colleagues approach the Irish Government on behalf of the workers who have lobbied us in London and appeal to them to honour their moral obligations to the work force?

Ian Pearson: I met trade union representatives from the company and the local management last month. I have been in contact with both shareholders, the Irish Government and ICI, and I am seeing the chief executive of ICI tomorrow. I take a close interest in the issue. It strikes me that four pension funds are involved and the position remains unclear. I am committed to doing all that I can to ensure that the work force get their full entitlement.

Nigel Dodds: I welcome what the Minister is doing to deal with the problem. The workers have been treated in a shabby and despicable way by a blue-chip British company and the Irish Government, with whom there is supposed to be a special relationship. May I urge him to do everything in his power to ensure that pension rights and other rights of workers, and the rights of creditors, are protected?

Ian Pearson: The Irish Government and ICI have put together a funding package of some Euro24.5 million for severance payments, and they have agreed to subordinate loans to ensure that creditors are paid. The important thing is that if jobs can be saved and a new investor can be found, we should be doing that. We must also make sure that the work force receive their full entitlement through pension arrangements and that the money owing to them in redundancy is paid out.

Grammar Schools

Teddy Taylor: If he will make a statement on the future of grammar schools in Northern Ireland.

Jane Kennedy: The consultation on the Burns proposals indicated an emerging consensus for the ending of the transfer tests, which the hon. Gentleman and I would recognise as the 11-plus, and I will be taking forward the review and working to abolish the transfer tests as soon as practical.

Teddy Taylor: Does not the Minister seek to abandon[Interruption.]

Mr. Speaker: Order. The House is far too noisy and it is unfair to those who are interested in these questions.

Teddy Taylor: Does not the Minister seek to abandon the shameful and destructive policy, initiated by Martin McGuinness, of abolishing the selection test? Does she agree that the absence of a clear judgment in these matters will undermine a facility that provides opportunities for able children from working-class homes to break through class barriers and ensures that Northern Ireland has better A-level results than England, Scotland or Wales?

Jane Kennedy: The hon. Gentleman is right in that the education system does well for certain very able pupils in Northern Ireland. I assure him that no decisions have been taken about academic selection or new post-primary arrangements. In the consultation, various suggestions were made for future arrangements, including options involving academic selection. My officials have been discussing those proposals with the education partners and parents' representatives, and they will continue to do so over the coming weeks.

Roy Beggs: Will the Minister give us a commitment that she will continue to support our grammar schools in Northern Ireland, just as her Government support the remaining grammar schools here in Great Britain? Will she acknowledge that it is now being acknowledged here that the comprehensive system has been failing pupils for far too long?

Jane Kennedy: The hon. Gentleman makes a forceful point, but he will know that the consultation on the Burns report indicated an emerging consensus, which, I hope he will accept, included political parties, on an end to the transfer test. I am confident that by working with our education partners and by keeping our focus on the interests of the child, we can develop a modern, fair education system that enables all children to fulfil their potential.

Economy

Ben Chapman: If he will make a statement on the Northern Ireland economy.

Ian Pearson: The Northern Ireland economy has witnessed significant improvements in recent years. Employment growth has been sustained with some 656,000 employees now in employment, the highest figure on record. Unemployment has also fallen considerably, now standing at 6.3 per cent., well below the European Union average. Forecasts for the local economy remain optimistic for the coming year.

Ben Chapman: Does my hon. Friend agree that in manufacturing, traditionally a weak area of the Northern Ireland economy, dramatic improvements in productivity have taken place, making Northern Ireland an ever more attractive market for inward investment? Does he agree also that that could not have been achieved without the stability and confidence provided by the Good Friday agreement, and that further progress in that direction may be hindered without its full implementation?

Ian Pearson: I totally agree. Manufacturing throughout the UK and Europe has been having a tough time in recent years, but in Northern Ireland it has been holding up very well. Over the last four years, manufacturing output went up by over 10 per cent., compared with a 5 per cent. decline in the UK. Business research and development increased by 40 per cent. last year, and productivity, which was 10 per cent. lower than in the UK, is now reaching UK levels. Those are all promising signs, and we must ensure that we continue to move forward and sustain, and improve on, that impressive track record.

David Burnside: The Minister must agree that economic progress depends on stability in the institutions of government, whether across the United Kingdom or in the regions. What are he and his colleagues doing to ensure that we have stable devolved government that is not under the constant veto of a paramilitary terrorist organisation, Sinn Fein, and that we are rewarded with accountable government at Stormont to help in the economic promotion of the Province?

Ian Pearson: My right hon. Friend the Secretary of State and others are doing all they can to make sure that we get the Assembly and the Executive back up and running as soon as possible. In the meantime, while we are asked to perform the job of Ministers, we will do so to the best of our ability to ensure that we have a stable economic climate in Northern Ireland, which is crucial to future business prosperity and success.

Andrew MacKinlay: Will the Minister discuss with the Secretary of State for Trade and Industry the possibility of introducing legislation to prevent the market distortion affecting the Northern Ireland economy whereby offers of retail products, life insurance and car insurance are restricted to the United Kingdom, excluding Northern Ireland? It is neither fair nor appropriate to a market economy that such discrimination is allowed to endure.

Ian Pearson: I thank my hon. Friend for that question. On a number of issues, the interests of Northern Ireland's economy are different and diverge from those of the United Kingdom. He mentions one of those issues; others include cross-border smuggling. They are all matters on which one would expect representations to be made to the UK Government, and they are.

Michael Fabricant: We now learn that the Chancellor of the Exchequer has had to borrow 10 billion in the past six months and that corporation tax has fallen by 14 per cent. Does the Minister agree that the worst thing that could happen to the fragile Northern Ireland economy would be a rise in taxes on corporations?

Ian Pearson: I dispute that. The simple fact is that the Northern Ireland economy is not in a fragile state. Manufacturing businesses are doing well, and we have a young, well-educated and highly committed work force. Northern Ireland is a great place for inward investment and we are holding our market share in that respect. There is every reason to believe that the prospects for Northern Ireland's economy are good and will remain good in future.

Northern Ireland Assembly

Eric Illsley: If he will make a statement on the prospects for establishing the Northern Ireland Assembly.

Paul Murphy: As I said in my reply to the hon. Member for Southwark, North and Bermondsey (Simon Hughes), we are working urgently with others to find a basis to restore the devolved institutions. I believe that doing so is of the utmost importance to the future of Northern Ireland.

Eric Illsley: Given the progress that has been made since the signing of the Good Friday agreementprogress to which my right hon. Friend has already referreddoes he agree that it is essential that the Assembly is re-established as quickly as possible?

Paul Murphy: Indeed I do. One of the great changes for the better in Northern Ireland in the past few years is that Northern Ireland people are taking decisions on behalf of other Northern Ireland people. The quicker we restore devolution in Northern Ireland, the better for everyone.

Patrick Cormack: Does the Secretary of Stateand the Prime Ministeraccept that the trust and confidence, the re-establishment of which he says is so necessary, would be re-established more quickly if he gave the House a categorical assurance that there was no question of giving fugitive terrorists an amnesty?

Paul Murphy: I think that the best thing that can happen is that, when we talkas we will tomorrow in Belfast and in the weeks aheadthe parties in Northern Ireland can reassure each other of the importance of settling those issues that are in front of us. That is a matter not only for the Governments, but for the political parties as well.

Eddie McGrady: Does the Secretary of State agree that the permanent re-establishment of devolved government in Northern Ireland can be achieved only by the complete fulfilment of the Good Friday agreement, endorsed by all participating parties. Does he agree that the current round of negotiations should refer only to matters as yet to be implemented under the Good Friday agreement, including those to be implemented by Government?

Paul Murphy: My hon. Friend is right that the chief reason why those talks have been held is that the institutions have been suspended because of lack of trust. At the end of the day, however, that trust can be restored by referring all the time to the Good Friday agreement itself and its implementation. That is a duty upon our Government, the Irish Government and all the parties working together.

PRIME MINISTER

The Prime Minister was asked

Engagements

Paul Goggins: If he will list his official engagements for 27 November.

Tony Blair: This morning, I had meetings with ministerial colleagues and others. In addition to my duties in the House, I will have further such meetings later today.

Paul Goggins: Has my right hon. Friend seen this week's report from UNICEF, which shows that in reading, maths and science this country is now one of the best-performing countries in the world? Does he recognise, however, that in many disadvantaged areas pupils and teachers still face substantial difficulties? What further action will he take to back his Government's commitment to raise standards for all pupils?

Tony Blair: It is correct that the UNICEF report found that Britain was seventh in the world for academic skills, above the United States of America. I shall quote briefly from the report:
	XThe United Kingdom, where hand-wringing over educational failures is a national pastime, fares better than all other countries in the European Union except Finland and Austria.
	The reason for that is the investment now going into schools in every single part of our communities. It is important, therefore, that we keep the investment programme moving forward, not cut it back, as some would have us do.

Iain Duncan Smith: Tomorrow, tube drivers will hold a strike ballot arising from the fire strike. Does the Prime Minister agree that such a strike would be secondary action?

Tony Blair: I agree that there is absolutely no cause for a strike because the Health and Safety Executive has made it clear that the tube is safe operating under London Transport's terms and conditions. It therefore follows that any strike, in my judgment, would be totally unjustified.

Iain Duncan Smith: The Prime Minister never said whether he felt that it was secondary action or not, which is critical. The whole of London's underground is likely to grind a halt, but he has not given a straight opinion. He knows that the Government own London Underground and that every member of its board is appointed by the Secretary of State. Will he now tell us whether the Transport Secretary, under his instructions, has told London Underground that it should use every available trade union law to stop the strike going ahead? In short, has it been told to get an injunction?

Tony Blair: First, it is for the court to decide whether it is illegal or not; it is not a matter for me or my right hon. Friend. However, as a result of the action already taken by London Underground, the total number not working normally is, I think, three. It is important that London Underground makes every effort to ensure that that is right. Of course, ultimately it is a decision for London Underground, but I am sure that it will enforce the law in whatever way it needs to.

Iain Duncan Smith: There are 8,000 people about to have a ballot, but the Prime Minister has given them no clear signal that if they take strike action it will be considered secondary action. Thousands of teachers and council workers have been on strike this week. Tube drivers and power station workers are now threatening secondary action that would paralyse the country, but the Prime Minister cannot say whether it is secondary action or not. After his answers today, does he not think that that will give a green light to all those who believe that they should have a right to strike? He made a promise in his manifesto that there would be no return to secondary action, but does he not think that people will believe that that was not true?

Tony Blair: There must indeed be no return to secondary action, secondary picketing or anything that is unlawful. All that I was pointing out to the right hon. Gentleman is that it is ultimately for the court to decide whether something is unlawful. I have just told him that the ballot on action tomorrow would be totally unjustified and that London Transport should do everything it can to enforce the law, so I hardly think that he can say that I have thereby given a green light to secondary action. That is a slightly extraordinary thing to say.
	Let me repeat the position: I do not believe that any action is justified. London Transport should use all the powers at its disposal, including those under the law, to enforce the law. I should have thought that that was plain enough even for the right hon. Gentleman.

Helen Jackson: I am not a killjoy[Interruption.] I am sure that my right hon. Friend is not one either, but is it not time that we stopped treating fireworks like a toy that children can play with when the nights are getting dark in September and October, thereby terrifying people in the community, and saw them as the fairly dangerous explosives that they are? Will he ensure that action on this issue is included in the antisocial behaviour order, on which we are legislating this Session?

Tony Blair: It is obviously important that we use the antisocial behaviour legislation to try to bear down on that problem. In the areas where we are piloting antisocial behaviour fixed penalty notices, such provision is already being made available to deal with the unlawful use of fireworks. If we were to use the fixed penalty notice route and some exemplary fines were meted out to those engaging in the practice, it would be stamped out fairly quickly. We keep all legislation closely under review; I am sure that the Home Secretary will have heard my hon. Friend's point. I know that it will be echoed by many hon. Members on both sides of the House.

Charles Kennedy: For a Government who promised economic stability, how embarrassed does the Prime Minister feel that we have had the longest period of manufacturing recession since the second world war and that business investment levels are now lower than during the Tory recessions of the 1980s and 1990s?

Tony Blair: It is correct that manufacturing has had an extremely difficult time, but if we look at the economy as a whole, we can see that there has been immensely strong growth. We have the lowest unemployment, inflation and mortgage rates for decades. Were we to follow the spending programmes of the Liberal Democrats, that would all be put at risk.

Charles Kennedy: The fact is that the percentage of investment in the European Union that comes to Britain was 28 per cent. four years ago, 20 per cent. last year and currently stands at 16 per cent. How low must it go before the Prime Minister takes action, particularly by setting a timetable for a referendum on entry into the single currency?

Tony Blair: I thought that we might get to that issue eventually. The position on the euro remains as it is: it has to be right for the economy as a whole. The right hon. Gentleman is right to say that there has been some falling off of investment in this country. Of course, it is mainly going to many of the accession countries such as Poland and Czech Republic, which obviously offer very low labour costs indeed. Overall, however, I hope that he recognises that the performance of this economy in the past five to six years has been an extraordinary one of high growth and employment, and low unemployment, inflation and mortgage rates. That is what we must and will preserve.

Hilton Dawson: Does my right hon. Friend share my grave concern that, at a time when we have seen real progress in children's services, we have also seen the tragic deaths of 13 children in young offenders institutions? Will he assure me that the work currently being done to develop policy for children will reflect the fact that prison is no place for children to be?

Tony Blair: Obviously, what my hon. Friend says about the need to improve conditions in some young offenders institutions is right. We must do two things. First, over the past couple of years various changes have been piloted in the institutions, including in Feltham in particular, where I think there has been most concern. Secondly, we are setting aside several tens of millions of pounds for a strategy of improving the services for young people in young offenders institutions. At the same time, my hon. Friend will agree that, unfortunately, there are young offendersoften very young peoplewho need to be in young offenders institutions or secure accommodation to protect the public from their behaviour.

Ian Paisley: The Prime Minister is aware that in the past two days my party has met the Minister with responsibility for security in Northern Ireland and the Secretary of State for Northern Ireland. We put one question to both: what is an act of completion? Does it consist of IRA-Sinn Fein repudiating and ceasing violence and being disbanded, or does it simply mean that they make a statement that they will give up violence? Can the Prime Minister tell us what he believes it means?

Tony Blair: I can. It is not merely a statement, a declaration or words. It means giving up violence completely in a way that satisfies everyone and gives them confidence that the IRA has ceased its campaign, and enables us to move the democratic process forward, with every party that wants to be in government abiding by the same democratic rules.

Eric Illsley: Is my right hon. Friend aware that the mere suggestion of university top-up fees is already causing anxiety in areas such as mine, which has a historically low take-up of university and higher education places? If collective provision is the right model for the national health service, should not it also apply to our education service?

Tony Blair: I am aware of the anxiety, which has been expressed in many quarters. My hon. Friend is right to express his concern. He knows that we will publish a review in January next year, but we do not intend to do anything that will put people off going to university. The Government have a proud record. In the past few years, we have increased the number of people who go to university by almost 100,000.
	However, our universities have a serious funding problem. Provided that everyone agrees that the status quothe huge backlog of repairs to infrastructure and university lecturers' pay increasing by only 5 per cent. in the past 20 years, when the figure for the rest of the economy is 45 per cent.is not an option, we should work out the right basis on which to change matters. That is fully consistent with the need to get more people into our universities.

Crispin Blunt: Why is the Prime Minister using the armed forces to break the firefighters' strike when he could have used the courts?

Tony Blair: That sums up the Conservative party in its current state. Is the hon. Gentleman seriously suggesting that we should not have made preparations for the armed forces to take over? What a ridiculous question to ask me! When the firefighters cannot provide fire service cover because they are on strike, it is right that our armed forces, who do a fantastic job, should stand in. If we refused to have the armed forces standing by, Conservative Members would be on their feet, accusing us of incompetence and chaos.

Colin Challen: I am sure that my right hon. Friend knows that I have organised a meeting on Friday evening for the residents of Tingley to consider policing and antisocial behaviour. They will be pleased that we have almost achieved our target of 130,000 police officersa record numberfour months in advance, but they will not be so happy that the distribution of officers does not appear to be equal throughout the country. Will my right hon. Friend take steps to ensure that everywhere, including West Yorkshire, gets its fair share?

Tony Blair: I am sure that the meeting in Tingley is one of many throughout the country to consider such serious issues. We are increasing police numbers throughout the country, but my hon. Friend's point is important. We need to ensure that they increase in areas such as West Yorkshire. I understand that, as well as the additional 250 police who were recently recruited to West Yorkshire police authority, more than 400 extra are on their way.
	I pay tribute to police officers in West Yorkshire. Their work has meant that street crime in the county has fallen by 45 per cent. in the past six months.

Iain Duncan Smith: The Prime Minister said that stakeholder pensions
	would transform the landscape of private provision.
	There are a third of a million company stakeholder schemes. How many of those schemes have any members?

Tony Blair: I assume that the right hon. Gentleman has the figures before him, but I can tell him that there are 50,000 additional stakeholder pensioners a month.

Iain Duncan Smith: The answer to the question is that of 330,000 company stakeholder schemes, 300,000 have no members and no money. It is no good the Prime Minister weaselling his way out. Will he tell us what proportion of occupational pension schemes are open to new pensioners?

Tony Blair: Again, I assume that the right hon. Gentleman is about to tell me. More than 1 million people have taken out stakeholder pensions. There are, as I said, around 50,000 a month. If that stretches over the next few years, it will amount to several million. I should have thought that that is a good record for stakeholder pensions.

Iain Duncan Smith: I do not think that the Prime Minister knows what a company pension scheme is, as he has given the wrong answer. More than half of those pension schemes are now closed to new members, and the latest evidence shows that the rate of closures has doubled in the past year. So occupational schemes are closing, stakeholder schemes are failing, and every year under Labour the number of people retiring without an occupational pension has risen. Given that his Chancellor's 25 billion tax hike has damaged pensioners, when the Chancellor of the Exchequer rises to speak today will the Prime Minister tell him to apologise for destroying pensions?

Tony Blair: No. It is correct that many pension schemes have had difficulties, for all the reasons that we know, not just in this country but in other parts of the world. However, when stakeholder pension schemes are attracting some 50,000 people a month, it is absurd to say that they have failed. It is correct that changes are necessary. They will be set out in the pensions Green Paper later this year, but in the end the single best guarantee for today's pensioners and tomorrow's pensioners is a strong economy. That is the economy that we have produced, but it is not the economy that the right hon. Gentleman's party produced when it was in power.

Gareth Thomas: May I draw the Prime Minister's attention to continuing concerns in my constituency, particularly in the lovely market town of Ruthin in Denbighshire, about the adequacy of flood prevention measures and flood defence? I seek my right hon. Friend's assurance that the Government are committed to long-term investment in flood defence and protection.

Tony Blair: We are committed to long-term investment in flood protection. Several hundred million pounds are going into it over the next few years. In addition, as my hon. Friend knowsI know that this is of concern in Ruthin and other places that have suffered from heavy floodingwe are working with the insurance industry to make sure that it provides proper cover for people. There are many difficulties that we need to sort out, and we are working closely with the industry in doing so. I can assure my hon. Friend that part of the investment in the comprehensive spending review was investment against the problems caused by flooding. There is one other thing with which I am sure that he and his constituents would agree: we also need to take action on climate change, for the benefit of Britain and the world more generally.

Adrian Flook: In a recent poll conducted by the Somerset County Gazette, 88 per cent. of respondents said that they wanted to keep Somerset county council. Will the Prime Minister confirm that if every voter in Somerset wanted to keep the county council, every urban voter in a unitary authority such as Bristol or Swindon could outvote them?

Tony Blair: As we have said, it is for people in the region to decide how their future is governed. The campaign that the Conservatives have been mounting about county councils is simply wrong.

John Robertson: As my right hon. Friend knows, 50 per cent. of calls to 999 centres are hoax calls. Will he make sure that the courts treat hoax callers in the manner that they deserve, and ensure that human life is preserved? Will he ensure that the punishment fits the crime?

Tony Blair: I entirely agree with my hon. Friend's strong condemnation of hoax callers. The figure for the country as a whole is about 7 per cent., which is still far too high. Hoax callers should know that they are liable not only to be disconnected but to be imprisoned. Several people have been arrested over the past couple of weeks in connection with hoax calls, and I hope that anyone who engages in this appalling practice will be treated with the utmost severity by the courts.

Peter Bottomley: In his first four years as Prime Minister, did the right hon. Gentleman notice the state of the universities and the pay of university lecturers?

Tony Blair: Yes, of course I did. That is one of the reasons that we introduced the first tranche of university reforms, following the Dearing report. If the hon. Gentleman is trying to say that we need to do even more, because of the rising number of people going to university, he is absolutely right. That is why I hope that, when we publish our review in January, the Conservative party will have the courage to make its own proposals if it does not agree with ours.

Debra Shipley: Given the Catholic Church's use of the Nolan guidelines to keep an abusive priest in office, does my right hon. Friend agree that the time has come for the Catholic Church, as an employer, to be required by law to remove such priests? Does he further agree that it is simply not good enough to hide behind risk assessment and forgiveness, as that does not protect children?

Tony Blair: Obviously, the law has to take its course. In my view, this is a matter for the Church, and the decisions that the Church takes should be taken only after the closest investigation of the facts.

Geoffrey Clifton-Brown: In view of the fact that lives are being lost in the fire dispute, and of the spreading of secondary action, is it not high time that the Government became personally involved in the negotiations, and asked the firemen to postpone their industrial action and evidence to the Bain inquiry on the modernisation of working practices in the run-up to Christmas? Will the Prime Minister now become personally involved to ensure that they postpone their industrial action until they have given their evidence to the Bain inquiry?

Tony Blair: The attempts by some sections of the Conservative party to try to squeeze every little bit of political capital that they can from this dispute are absolutely extraordinary. If the hon. Gentleman is suggesting that the firefighters are somehow under some misapprehension about our wanting them to call off the strikewell, I would have thought that they would have got that message by now. As for their giving evidence to the Bain inquiry, we have been saying throughout that that is what they should do. The only way in which this dispute is going to be settled is by the employers and unions agreeing to debate in detail the prospects for modernisation, giving a better deal over and above the 4 per cent. That has been the position throughout, and it is absolutely right that it should remain the position. It is for the employers and the unions to negotiate around it.

John Lyons: It has been 28 years since the Turkish army invaded Cyprus. Over that period, 1,500 people, including children, have gone missing. Will my right hon. Friend take up this issue as a matter of urgency with the new Turkish Government? Mothers and fathers need to know what has happened to their loved ones. Have they been murdered or tortured? Have they been imprisoned? Will my right hon. Friend please do something about this?

Tony Blair: My hon. Friend raises a serious issue. There is every possibility of trying to resolve it in the context of an agreement on Cyprus. I genuinely believe that the United Nations plan that has been put forward offers the greatest prospect for a final settlement of the Cyprus issue than we have had for many decades, and if that can been agreed by the parties involved some of the traumatic and difficult issues that my hon. Friend has raised could be resolved. Obviously, we raise individual cases all the time, but the best way of dealing with the matter comprehensively will be in the context of an agreement to that settlement.

Marion Roe: As my constituency is close to Stansted airport, will the Prime Minister explain to my constituents whether the Government's consultation on future airport expansion is essential and balanced, as Ministers claim, or irrational and unfair, as the High Court concluded yesterday?

Tony Blair: The High Court decision, I think, was on the exclusion of Gatwick and the reason for that is quite simple: we had an agreement that we would not put Gatwick in the consultation. However, the court's decision rules otherwise.
	In relation to the airport proposals, of course I understand why the hon. Lady's constituents are concerned. It is always difficult when there is a consultation process and everything has to be put into it, but that does not mean that decisions have been taken. However, as the High Court decision showed, if we were to exclude certain things, we would be accused of conducting an unfair process too. It is important that we continue with the consultation process in the way that I have describedwe look at absolutely every optionbut her constituents should not think that we have made up our minds on it, because we have not.

Andrew Dismore: My right hon. Friend has referred to the UN settlement plan for Cyprus, which has been welcomed by the Greek Cypriots as the basis for further negotiation and in relation to which the Turkish Cypriots have yet to make a judgment. Will he assure the Greek Cypriots, who are very concerned, that that delay will not in any way prevent their entry to the European Union at the Copenhagen summit?

Tony Blair: It was partly as a result of the representations of this Government that we made it absolutely clear that Cyprus should be able to join the EU, even if there is not a final settlement. However, it is important, obviously, that we want there to be such a settlement. I have had good conversations with the new leadership in Turkey about that issue. I hope that the UN proposals can at least be a basis for concluding these negotiations reasonably quickly. If that happens, the Cyprus issue would be resolvedCyprus, in any event, will join the EUand relations between Greece and Turkey could improve. That would be of enormous benefit to the whole region.

John Taylor: Will the Prime Minister confirm that modernisation means 10,000 firefighters losing their jobs?

Tony Blair: No, I will not confirm that. The truth is that 20 per cent. of the firefighters are due for retirement for demographic reasons in any event. That allows us to sit down and talk about those who are necessary to give the proper manpower for the fire service. Of course, there will be people retiring from all public services. For example, some 12,000 people have retired from the police and 30,000 have retired from the teaching profession, but there are more police officers and more teachers in employment today. So, the Deputy Prime Minister was sayingwe know this; indeed, it was published by the Government Actuary's Department last yearthat 20 per cent. will retire for demographic reasons, but that is simply one more opportunity to sit down and get the essential modernisation that the fire service needs.

Margaret Moran: Is my right hon. Friend aware that Monday was international day for the elimination of violence against women? In that context, may I thank him for his personal commitment and that of this Government to introduce the first comprehensive legislation on domestic violence in this country? However, is he aware that, although legal protection is vital, so too are support and advocacy services for women and children? Is he aware that most Government initiatives do not fund outreach, helplines or children's services and that 40 per cent. of local authorities

Mr. Speaker: Order. That was the fourth question.

Tony Blair: I am grateful for what my hon. Friend says about the measures that we are taking on domestic violence. It is a real problem, and she rightly draws attention to it. We are not simply taking measures; we are also investing, I think, almost 11 million specifically in programmes to try to diminish domestic violence. I entirely agree that it is important that we carefully measure any forthcoming legislation to see how it bears on that appalling problem.

Stansted Airport

Mark Prisk: What representations he has received concerning the Government's proposals for Stansted airport.

Tony Blair: The Government continue to receive a large number of responses to the consultation document, XThe Future Development of Air Transport in the United Kingdom. Ministers and officials in the Department for Transport have also met a wide range of organisations as part of the consultation.

Mark Prisk: Given the High Court's decision that the Government's consultation is indeed irrational and unjust, will the Prime Minister clarify for my constituents and for the House why his Transport Ministers specifically overrode the advice that they were given, which was that they should include Gatwick in the first place? That was the advice; why did they ignore it?

Tony Blair: We excluded Gatwick because we had given an undertaking to exclude Gatwick. Yesterday's court hearing found that, in any event and despite that, we should include Gatwick. The Secretary of State for Transport has said that that will be done, and that is of course right. The hon. Gentleman says that it was decided that it was unfair, arbitrary and irrational; the reason is the one that I gave. Many people around Gatwick will feel aggrieved that it has gone back in when we had given a specific undertaking that it would not. However, the court has decreed that it should go back in, and that is what will happen.

Engagements

Vernon Coaker: Will my right hon. Friend look at the number of youth workers in our communities? Many of us feel that an enhanced and improved youth service would do much to tackle antisocial behaviour in our communities.

Tony Blair: It would. One reason the Government are putting a huge investment into the Connexions partnerships, which give proper guidance and career advice to young people, is precisely because we know that, along with increased investment in education and sure start, such investment is not just in young people but in a more secure, safer and fairer Britain. That is the Britain that we shall continue to fight for.

Speaker's Statement

Mr. Speaker: I have a brief statement to make to the House. I have to inform Members that I have received the following letter from the Clerk of the House:
	XDear Mr. Speaker,
	I am writing to let you know formally of my desire to resign as Clerk of the House at the end of the year.
	I entered the service of the House in September 1961, and I first sat at the Table of the House in 1977. By the time I resign, I shall have been Clerk of the House for exactly five years. Two years ago, I had the further privilege of being appointed the First Chief Executive of the House Service.
	It has been an honour and a unique privilege to serve the House of Commons over these 41 years, and especially to do so as its principal adviser on privilege and procedure. I shall always be grateful to the occupants of the Chair and Members in all parts of the House, past and present, for their courtesy and friendship over that long period.
	For at least the past decade, the House's procedures and services have adapted to meet new demands and challenges at a pace which would have startled my colleagues in 1961. I hope we have been generally successful in coping with change while maintaining the traditional high standard of service. If so, the credit must go to all those men and women in the six departments of the House on whose loyal service so much depends. It has been a privilege for me to be associated with them.
	I shall leave the service of the House with regret, but I shall do so in the knowledge that no other career could possibly have provided as much satisfaction and opportunity for service.
	Yours sincerely,
	William McKay

Robin Cook: Members on both sides of the House who have benefited from the sound and impartial advice of Sir William McKay over four decades will regret the announcement that you, Mr. Speaker, have just made to the House. I realise that Members on both sides will wish to express their appreciation of his service, and therefore we shall shortly table a motion on his retirement, which will give Members the opportunity to pay tribute to him.

Pre-Budget Report

Gordon Brown: Last year, of the major economies, the British economy was the fastest growing. This year, 2002, amid the worst global slowdown for almost 30 years, the British and north American economies will grow faster than all other major economies. I can report that next year, in 2003, Britain and north America are now forecast, even in a still uncertain and unstable world, to continue to be the fastest growing of all the major economies.
	Today, as I examine in turn world and British growth, the balance of the economy, including the housing market and the position of manufacturing, and the fiscal figures now and for the future, I will report that with the lowest inflation for 40 years and long-term interest rates also the lowest for 40 years, Britain's monetary and fiscal framework is meeting the challenges of each stage of the economic cycle, and we will tolerate nothing that will put that hard-won stability at risk.
	As Britain meets the challenges of the wider global economy, the pre-Budget report will also outline further labour market, capital market and product market reforms to improve British science, skills and enterprise, and I will outline proposals for continuing public service reform and tax and benefit modernisation showing that, both in Britain and abroad, strong economies and fair societies advance together.
	I start with the international economic outlook. Twenty of the world's biggest economies, accounting for 60 per cent. of the world's outputthe United States, Japan, much of Europe and Latin Americahave been or are in recession after what has been the sharpest slowdown in global economic activity for almost 30 years, indeed the biggest contraction in industrial output in the world's major economies since 1975. World trade growth, which held up through both world recessions of the early 1980s and 1990s, fell 12 percentage points last year, and while trade growth resumed early this year, it has faltered yet again. It is one of the many reasons why, at an international level, the British Government are working for an early resumption of the world trade talks and why, at a European level, we must curb industrial and agricultural protectionism.
	While the present political and economic uncertaintiesthe continuing aftermath of 11 September, unfolding events in Iraq, the impact on oil prices, concerns about equities and corporate standards, continuing trouble in the IT sector and current account imbalanceshave all caused business investment to fall sharply since 2000 in every major continent, the challenge for the British economy in this more uncertain and unstable world has been to steer a stable course, combining low and stable inflation with sustained demand growth and with high levels of employment.
	I can report that 175,000 more people are in employment in the British economy this year than last year and in total 1 million more work force jobs have been created since 1997. Our unemployment rate is lower than in Japan, America and the euro area for the first time for 50 years.
	Our monetary and fiscal foundation, which is based on the independence of the Bank of England, imposes a symmetrical target for inflation, requires debt at low levels, holds to tough fiscal rules over the economic cycle and is thus designed not just for times of high growth, but for a global contraction with all its attendant difficulties. It is because the Bank of England has established credibility through year after year meeting our 2 per cent. symmetrical inflation target that it has been able, supported by fiscal policy, to sustain growth in our economy. It is that same symmetrical inflation target, which was designed to prevent both deflation and inflation, that explains why the Bank of England is rightly vigilant not only about the continuing weaknesses of equities, trade and investment and of G7 current account imbalances, but about domestic risks, including the need for a sustainable housing market and for affordable pay settlements across the economypublic and private sector alike. We will continue to give steadfast backing to the Bank of England and the Governor, Sir Eddie George, who retires next June, in all the difficult decisions that have to be made.
	It is because we are determined both to have stability and value for money in reformed public services that, just as in the private sector, public sector pay rises must be set at a sustainable rate and justified by productivity. When inflation is around 2 per cent., we should not put our hard-won stability at risk by yielding to inflationary and unaffordable pay settlements, whether in the private or public sector. That would put low inflation and low interest rates in jeopardy and damage the whole economy. To continue to steer a steady course, we must hold firm in our demand for discipline in pay setting across the economy.
	Let me give the full detail of the economic forecasts. I can report that inflation will meet our target of 2 per cent. this year. We now forecast inflation to be 2 per cent. next year and 2 per cent. from 2003 for every subsequent year of our forecast periodhaving met our inflation target in each of the past five years, we will continue to do so in the future.
	With that platform of domestic stability and an expected world trade recovery, to rise next year by an estimated 5 per cent., we can forecast consumption to grow in 2003 at a sustainable pace of 2 to 2 per cent. with the housing market slowing. We forecast manufacturing output rising by 1 to 2 per cent., and business investment by 2 to 3 per cent. to make for more balanced economic growth.
	Across the industrialised world, including in Britain, since the further slowdown since this spring forecasts for growth this year have been downgraded. In the euro area, gross domestic product growth is forecast to be 0.8 per cent.; in France, 1 per cent.; in Italy, 0.4 per cent.; in Germany just 0.4 per cent., and in Japan it will be minus 0.9 per cent.
	For the UK, GDP growth is forecast to increase by 1.6 per cent. this year. It will rise to 2 per cent. to 3 per cent next year, rising again to 3 to 3 per cent. in 2004. Some have argued that Britain is least well placed to cope with global slowdown. In fact, taking growth last year, this year and next year together, Britain is not the weakest but the strongest of the major economies. And while Japan, America and Germany have all been in recession, Britain has now grown consistently in every quarter for the past five and a half years.
	As with monetary policy, so our fiscal policy is designed to help sustain growth at every stage in the economic cycle. Our fiscal rules are set for the long term and based on deliberately cautious assumptions, including for revenues. These assumptions, which are independently audited by the National Audit Office, mean that when stock market values fall we take that fully into account, and not just in assessments of this year's current revenues from stamp duty, capital gains tax and corporate taxwe also build such falls fully into revenue projections for future years. The assumptions include not only a cautious view of tax receipts from growth, of oil prices, and of the impact of revenue gains from, for example, anti-fraud strategies, but cautious assumptions about unemployment, where we claim no social security savings when unemployment is forecast to fall.
	From 1997, we also took decisions to freeze spending for the first two years, achieving surpluses of 30 billion; to cut debt from 44 per cent. of GDP to 36 per cent., and then to use the 22 billion spectrum auction to repay even more debt; and regularly to achieve not just a current balance but a large surplus. In each year since 1997, we have met our two fiscal rules, with current surpluses worth a cumulative 58 billion, and debt far below 40 per cent. of national income. With debt interest payments 7 billion a year lower than in 1997, debt interest consumes a smaller share of national income, this year as last year, than at any time since 1915. So while some have, in the past, criticised this long-term and deliberately cautious approach, we are, with current surpluses and historically low debt, able at every stage of the economic cycle to meet our fiscal rules, including in the cautious case.
	Let me provide the detailed figures. Figures for our current Budget for this year, 200203, and for the five years to 200708 are minus 6 billion, minus 5 billion, plus 3 billion, plus 5 billion, plus 8 billion and plus 10 billion. So we meet our golden rule over the cyclenot just achieving a balance but with an estimated surplus at 46 billion. We meet the golden rule on the cautious case, too. Taking the full economic cycle into account, the current surplus for each year is forecast to be 0.2 per cent. of GDP this year, 0.3 per cent. next year, then 0.6 per cent., 0.5 per cent., 0.6 per cent. and 0.7 per cent. in the four years to follow.
	Our second rule is the sustainable investment rulethat over the cycle net debt should be kept below 40 per cent. of national income. Debt this year is 41 per cent. of GDP in the US. It is rising to 43 per cent. in France, to 45 per cent. in Germany, to 54 per cent. in the euro area, to 70 per cent. in Japan and it is almost 100 per cent. in Italy. I can report to the House that, in Britain, net debt this year and in future years will be at 31 per cent. this year, then 32.1 per cent., 32.4 per cent., 32.6 per cent., 32.7 per cent. and 33 per cent. So we will comfortably meet our sustainable investment rule, and we shall do so over the cycle, and in every year.
	Our commitment to meeting these fiscal rules is not just for this year and this economic cycle, but for the long term, so I am also publishing today a report that examines the sustainability of Britain's fiscal position decade by decade, and compares our position with those of other countries. It shows that if we take account of population change, and the cost of ageing to public spending, the British fiscal position in this period is sustainable, and in a strong long-term position compared with those in other countries.
	I have said that our fiscal framework is designed not only so that we make the right decisions when the world economy is growing, but so that it is robust so that at all times we meet our fiscal rules. An alternative approach has been put: that, instead of our holding firm to this long-term course, this stage of the economic cycle would be the time to cut spending and borrowing. I have examined such an approach. It would lead directly to depressed demand, rising unemployment, and the old familiar boom-and-bust approach[Interruption.] Oh yes. It would lead to the old familiar boom-and-bust approach of capital investment in infrastructure that is vitally needed being slashed, and hard-won stability would be put at risk.
	In the last world downturn 10 years ago, Britain was bound into such a position, when inflation was high, debt was rising fast and the fiscal disciplines were not being met. But today, in this world downturn, with a foundation of historically low levels of inflation and debt, such an option would be neither competent nor prudentbecause, after the decisions we have made, we can comfortably meet our fiscal rules, we can fulfil our spending plans, and we can borrow for investment across the economic cycle.
	Figures for net borrowing for this year and for future years are 20 billion, 24 billion, 19 billion, 19 billion and 20 billionthat is, 1.9 per cent., 2.2 per cent., 1.6 per cent., 1.6 per cent., 1.5 per cent. and 1.5 per cent. of gross domestic product. That compares with a deficit 10 years ago of 8 per cent., equivalent to an 80 billion deficit today, and to an average deficit of 6 per cent. in the early 1990s.
	I can confirm that this year, and each year in our forecast period, we are well within the Maastricht criteria, and that the Treasury will publish the assessment of the five tests on the euro by June next year.
	If we take the full economic cycle into account, net borrowingwhich is forecast this year, cyclically adjusted, to be 2.7 per cent. in the United States, 2 per cent. in France, nearly 3 per cent. in Germany and 7 per cent. in Japanis, in Britain, just 1.2 per cent. this year, and 1 per cent., 1.3 per cent. and 1 per cent. for the next three years.
	So, in both monetary and fiscal policy, with the lowest inflation and the lowest long-term interest rates for 40 years, as well as the lowest unemployment for 25 yearsand we are able to meet our spending plans in fullthe right approach is to hold firm to our long-term course.
	As I conclude this section on monetary and fiscal policy, I wish to thank Sir Edward George, whose period of office as Governor of the Bank of England ends in June next year, for the steady hand he has consistently shown in the leadership of the Monetary Policy Committee since we made the Bank of England independent in 1997. In welcoming the announcement this afternoon of the appointment by Her Majesty the Queen of the new Governor of the Bank of Englandthe deputy Governor for the last five years, Mr. Mervyn KingI can assure the House that the same steady grip will continue. It is that steady handthat long-term strength of purpose in monetary and fiscal policythat, in testing times, is keeping our economy stable and growing to meet our long-term goal of prosperity for all, and we will do nothing to put that steady approach and our hard-won stability at risk.
	If stability is the precondition for economic progress, enterprise is its driving force. And Britain today is challenged by a long-term global restructuring of industrylow value-added production shifting from the highly industrialised to the industrialising countries; competitive advantage in manufacturing and services increasingly coming from high value-added technology-driven products.
	In the next wave of globalisation, which is now upon us, it is the flexibility of our product, capital and labour markets, the strength of our science base, the level of British research and development and the scale and dynamism of knowledge transfer from our universities to business that will drive our productivity growth and thus future prosperity.
	Building on the independence of our competition authorities, the surest route to British companies becoming global champions is to extend competition and open up new markets at home. The public sector must also meet this test, and the investment that we make must be matched by continuing reform. First, in central Government contracts worth 14 billion a year, the Office of Government Commerce will maximise competition and encourage bids from the widest range of companies, small as well as large. Secondly, the Office of Fair Trading will scrutinise proposed public sector regulations to assess their competitive effects. Thirdly, we will use the discipline of the market to deliver value for money through private finance initiative projects worth 30 billion, which will include large-scale regeneration projects, while recognising the limits of markets in areas such as health care, education, defence and policing. Fourthly, to maximise efficiency in dealing with the Government's own businesses, we are announcing today the creation of a new shareholder executive.
	In January, we will receive and respond to the Higgs report on the role of non-executive directors.
	Having cut corporation tax to 30p and having consulted business on further corporate tax reform, we are considering detailed proposals to reform the tax treatment of capital assets, the use of losses and of trading and investment companies. To stop tax avoidance, measures announced today will root out abuse of the VAT regime, and we will be tightening rules governing employee benefit trusts, industrial building allowances and profits on sales of extended warranties.
	I turn to measures to help small and medium-sized businesses. Following our cut in small business corporation tax to 19 per cent. and the cut in the starting rate from 10 per cent. to zero, the Secretary of State for Trade and Industry is today announcing the extension of eligibility to the small firms loan guarantee scheme to include businesses with turnovers of up to 3 million a year in a wider range of sectors. Some 400,000 businesses in all are now eligible.
	Following our deregulatory measures for flat-rate payment of VATunder which, from April, 650,000 small businesses are no longer required to report on each VAT transactionthe pre-Budget report will consult small businesses on extending the scheme. Following the exemption of 200,000 firms from the requirement of a statutory audit, we will consult next year on the same deregulation for medium-sized firms.
	To help small and medium-sized firms export and build modern manufacturing strength, the Secretary of State for Trade and Industry is also ensuring that from today the Manufacturing Advisory Service will extend to every region of the country; and in response to concerns about rising insurance costs, the Secretary of State for Work and Pensions is undertaking a formal review of the operation of employers' liability insurance.
	To build stronger local economies in each region and to devolve decision making out of Whitehall, in the north-west, east midlands and west midlands we are devolving business support services from Whitehall to the regions, and in the north-east, north-west, south-east and east, we are devolving to the regions management of the skills budgets.
	Because the enterprise culture that we want to see starts in our classrooms, the Secretary of State for Education and Skills is following the Davies report, announcing, over three years, 75 million to promote education in enterprise in our schools and colleges. To encourage local initiatives in enterprise, we are consulting on allowing local authorities to keep additional rates income from the creation of new businesses in their area.
	To match the proposed greater flexibility in the planning system with measures to increase the affordability and numbers of houses, the Deputy Prime Minister is publishing the communities plan in January.
	For high unemployment areas, where the answer is more economic activity and more enterprise as the route to more jobs, we are today, jointly with the Small Business Service, publishing details of 2,000 new enterprise areas, in which, following state aids clearance which we expect in January, not only will we abolish from Budget day stamp duty for all business property transactions in these areas and, with the 25 per cent. community investment tax credit, cut the cost of investing in these areas, but we will give local authorities powers to relax requirements for detailed planning permission. In pilot projects in high unemployment areas, we will test a more intensive approach, estate by estate, of interviews, training and job search services, matched by benefit sanctions so that we can help the long-term unemployed back into work.
	I have two further announcements on business taxes. From 1 January, we will abolish all royalty taxes on North sea oil and gas. Following the consultation that I began in my last Budget on the future of bingo tax on player stakes and whether to replace it with a tax simply on bingo companies' profits, I am sure that my decision having covered all the numbers in this areato abolish in the Budget bingo duty will be welcomed on both sides of the House.
	Our charity tax reliefs are worth an additional 2 billion a year, and I can announce today that we will extend for one more year the Government supplement on payroll giving. To match our initiatives on giving with initiatives encouraging volunteering, the Home Secretary and I will consult business on a new corporate volunteering initiative. Based on the success of the United States Americorps, we will pilot a financial scheme to help British young volunteers from lower-income backgrounds take a year out after school to undertake community service.
	We also have a commitment to protect the environment for future generations, so we are publishing today a detailed paper setting out our approach to the environment. We will consult on what will be a revenue-neutral proposal to raise the landfill levy by 3 per tonne per year from 200506. On environmentally based fuels, I can also announce that, for bioethanol road fuel, we will reduce the duty rate by 20p per litre.
	The modern route to competitiveness also demands that Britain's most innovative companies work ever more closely with Britain's enterprising research universities. Today, the Secretary of State for Trade and Industry is beginning a review of Government support for innovation, and she and I have asked the former editor of the Financial Times, Mr. Richard Lambert, to examine how, building on our research and development tax credit and the university challenge and higher education innovation funds, the long-term links between British business and British universities can be strengthened to the benefit of the whole British economy.
	Since 1997, the new deal has been helping the young, lone parents and many disabled people back into work. The priority now is to focus, too, on how we help young people and adults to move up the skills ladder. I can therefore announce that we will use the remaining surplus from the windfall tax and, at a cost of 130 million, extend to a quarter of local learning and skills council areas the new employer training pilots, in which the Government support wage and training costs in return for employers providing time off so that employees can get proper training.
	To spearhead what I believe the whole country wantsthe expansion of modern apprenticeships so that nearly a third of young people are covered by 2004a new modern apprenticeship taskforce will be headed by someone who knows a great deal about training and skills, the chairman of Manchester United football club and chief executive of Centrica, Sir Roy Gardner. In addition, following the success of our new university for industry, with half a million students already, and talks with the banks, we are now going to consult in detail on how we expand training and management courses for small businesses.
	We will also continue the expansion of work permits for managed migration, which was begun by the Home Secretary. He and I are extending the highly skilled migrant programme, and through a new unit we will help small firms seeking to recruit skilled workers from overseas.
	Our policy is to combine enterprise with fairness. To continue to make work pay more than benefits, we are, from April, extending the principle of the working families tax credit to single adults and couples aged 25 and over without children. Couples with wages of less than 280 a week, or 14,000 a year, and single people with wages of less than 10,500 a year will stand to receive more money from the new working tax credit, taking forward our belief that an enterprising economy and a fair society advance together.
	A flexible, efficient labour market must not only promote employment but be fair to parents. Next month, in a joint Department of Trade and Industry-Treasury report, we will publish new proposals for enabling parents to make real and effective choices on balancing work and family life.
	Building on our rise, from April, in maternity pay to 100 a week, the first ever paternity and adoption pay, the new tax credits that we are introducing and the first ever national child care strategy, we will consider further reforms: first, new tax and national insurance incentives so that we can expand employer supported child care; secondly, paying the child care credit for approved home child care by carers who are not already childminders; and, thirdly, increasing flexibility in parental time off, including giving fathers time off to attend antenatal care.
	Our goalstability and prosperity for allmeans also fulfilling our goals to tackle child and pensioner poverty. Following last week's social security uprating, the starting level for the new child tax credit, taken with child benefit and now to be paid direct to the mother, will be 1,400 a year for those with incomes below 50,000; between 800 and 1,400 a year, for those with incomes of 50,000 to 58,000; and for 2 million of our lower income families, 2,800 for the first child and 4,800 for a two-child family as the child tax credit, based on support for all and most support for those who need it most, becomes the most powerful weapon for tackling family poverty.
	That same progressive principle underlines our proposal that all children have a child trust fund that builds up year by year to be drawn upon at the age of 18. We are now proceeding to detailed discussions with a range of providersthe banks, building societies and friendly societies.
	Now that the Secretary of State for Work and Pensions has also announced the pension rise next April from 75.50 to 77.45, and to 79.40 at least by 2004, the Government can also announce the levels of the new pension credit. From next October, instead of penalising modest savings and small work pensions, it will reward savings.
	In the typical constituency of Members of the House, 7,000 pensioner households will benefit. That is couples with total incomes of 200 a week or less, and single elderly people with 139 a week or less. They stand to benefit from what is 2 billion extra that is being paid out in pensions. Let me give the House the figures: a pensioner couple with income of 150 a week will receive 21.50 a week extra. That is 1,100 more a year. On an income of 160 a week, it is 17.50 a week or 900 a year. With an income of 170 a week, it is 13.50 a week or 700 a year. A single pensioner with 110 a week will receive 11.60 a week, or 600 a year on top of their pension rises. For 5 million pensioners, this will be the biggest increase in pensions since the old age pension was introduced. I can also announce that the minimum income guarantee for single pensioners will be 102.10 a week as we seek security and dignity in retirement for every single pensioner in our country.
	When, next month, the Secretary of State for Work and Pensions publishes the Government's Green Paper on pensions, this will include our proposals to simplify the tax treatment of pensions. I can confirm that the tax-free lump sum payment to retirees will remain. Existing tax reliefs for pension contributions for employees, the self-employed and employers will also remain.
	I have two more announcements to make. Because we have built sound foundations of low debt and low inflation and are today meeting our fiscal rules, we have rejected the view that we should cut back our spending plans at home and abroad. So I can not only confirm that we will fund our planned investments: by 2006, there will be 8 billion more a year for local authorities; 15 billion more a year for education; 63 billion more a year for public services; and by 2008, for health alone, there will be 41 billion more a year to be paid for by our national insurance riseall to be matched with reform.
	But we can also, amid global uncertainty, do more to meet our international obligations. It is right in the new figures presented today, consistent with past Treasury practice, to set aside to meet our international defence responsibilities a provision of 1 billion to be drawn on if necessary. We must not only meet the global security challenge; there is today not only a new imperative but, I believe, a new opportunity to meet the global poverty challenge.
	In the last five years, through the Prime Minister's Africa initiative and the tireless work of the International Development Secretary, Britain has spearheaded the fight for debt relief and social justice for the poorest countries. I can tell the House that having already agreed $62 billion of debt relief for 26 countries, our aim is now $100 billion for the 38 countries in total that stand to benefit from the cancellation of debt. I thank all Members on both sides of the House and all churches, faith groups and non-governmental organisations in our constituencies for their tremendous work.
	But because at this critical moment we must move forward, I have held discussions over recent days with Finance Ministers from America, France, Germany, Italy and other European countries, as well as with the heads of the International Monetary Fund and the World Bank. I can inform the House that Britain is now proposing a new international development finance facility, with public finance leveraged up by long-term international commitments, so that we can raise the amount of development aid for the years to 2015, with a step change from $50 billion a year to $100 billion a year, so that we can meet by 2015 the millennium development goals, including that poverty be halved, that child mortality be reduced by two thirds, and that every single child has the right to primary education.
	Having written as chairman of the International Monetary and Finance Committee to all fellow Finance Ministers, and to the World Bank and the United Nations, I can tell the House that we will, as a Government, be prepared to provide a British commitment to help underpin that plan. The Secretary of State for International Development and I are now asking other countries to join with us. I believe that all parties in this House will wish to support this British initiative for global justice, so that we not only win the fight against terrorism, but win the peace.
	In conclusion, we have been tested by world events and have resolved to steer a steady course. That steady strength of purpose will continue, and we will honour our commitments to invest in public services, to advance enterprise and fairness and to meet and master the global challenges. I commend this statement to the House.

Michael Howard: I begin by drawing attention to my declaration in the register and express my gratitude to the Chancellor for advance sight of part of his statement, blank pages and alla total of eight minutes of it.
	I start on a note of consensus. I welcome what the Chancellor said in his closing remarks about the relief of global poverty. He said that he welcomed the support that that would receive from all quarters of the House, and he was absolutely right. We support those measures.
	I must congratulate the Chancellor on something else. Up to now, he has been overshadowed by the Prime Minister, but at last he has come into his own. He is being paid the supreme accolade of having a song dedicated entirely to him. It is written by Kenny Jones and Robert Hart. [Interruption.] The song is released later this week, and I can give the House a preview. [Interruption.] It is called XMr. Brown, You're Robbing Me and its lyrics include the lines:
	XGiving with one hand, taking with the other.
	Shatter your dreams. Then you run for cover.
	But the Chancellor has not been able to run for cover today. This is a moment of humiliation for him. [Interruption.]

Mr. Speaker: Order. The Chancellor was heard and the right hon. and learned Gentleman has to be heard.

Michael Howard: I quite understand, Mr. Speaker, if Labour Members do not want to listen to this.
	The Chancellor was forced to admit that his forecasts on growth were wrong; his forecasts on revenue were wrong; his forecasts on borrowing were wrong; and his forecasts on his deficit were wrong. These are the downgraded forecasts of a downgraded Chancellor. For weeks on end, he and his spin doctors have been trawling around looking for alibis. In the words of the Financial Times, he has been Xrehearsing his excuses.
	Everyone is to blame for the fact that the Chancellor got his forecasts wrong except the Chancellor himself. In Thursday's Financial Times he blamed it on the fall in world trade between 2000 and 2001, but in his Red Book, at the time of his Budget forecasts, he said that world trade was estimated to have contracted in 2001 and grown only slowly in 2002. At the CBI and in the House last week he said that we are seeing the sharpest contraction in world economic growth since 1974, and he is wrong about that too. We had world growth of 2.2 per cent. in 2001, and the rate is expected to be 2.8 per cent. in 2002, but in the early 1990s we had three years when world growth averaged just 1 per cent. a year.
	The Red Book made it clear that independent forecasters took a much more realistic view of prospects than did the Chancellor. His central forecast for 2002 was for growth of 2 per cent., but independent forecasters said that it would be 1.9 per cent., and so did the OECD just eight days after the Budget. What were those independent forecasters telling the Chancellor at the time?
	XEconomists were surprised by the strength of the forecasts,
	noted The Independent. Growth projections in the next year or two were Xvery ambitious, said Deutsche Bank. XIt is not prudent, said HSBC economists. Everyone knew about thisexcept, apparently, the Chancellor. Indeed, far from heeding any of that independent advice, the Chancellor increased his forecast for growth in 2003 and for longer term trend growth. He thought that everyone else was wrong and he was right.
	Today the Chancellor announced a borrowing figure of 20 billion for next year. Does not that demonstrate how dramatic is the deterioration in the public finances? His forecasts for borrowing over five years have risen from 30 billion in last year's Budget, to 66 billion in last year's pre-Budget report, to 72 billion in this year's Budget and to over 100 billion for the next five years.
	The Prime Minister looks surprised; the figures obviously take him unawares. We know that the Red Book is not his favourite reading but he ought to take a little more interest. There they sitwhat a shambles, what a shower. XBrown and Blair, the posturing pair. They are very good at taxing the people of this country; they are very good at spending the people's money; they are very good at wasting the people's money and they are very bad at delivering the improvements that the people want.
	The Chancellor said that none of that matters as long as borrowing balances over the cycle, but will he comment on the view of the Ernst and Young item club that half the expected revenue shortfall for this year could be structural rather than cyclical? Will he comment on the view of the Financial Times that he took Xthe most unusual years as the basis of his calculations, something that the newspaper says Xseems daft? What is more, he cannot even say when his much vaunted cycle starts and ends. When I ask him about that he refers me to the Red Book, but the Red Book says that these things are very difficult to judge. It says that the start date for the cycle is provisional and that it is an assumption. Why on earth has the Chancellor spent the past five years claiming that his fiscal rules are rock solid when he cannot even tell us the start date of the cycle on which they depend?
	Is not the end of the cycle even harder to predict, and is not that rather convenient for the Chancellor? Does he agree with the National Institute of Economic and Social Research that the current cycle will end early next year or early in 2004 and that he will not then be able to balance future deficits against past surpluses? That seemed to be the Treasury's view in the spring.
	Is the Chancellor planning to do what has been suggested and try to make the cycle last longer? Why did the Treasury brief the press, first, that the cycle was about to end and then that it would end as late as March 2005? He told the House last week that the Government's fiscal policy
	Xcan adjust to the economic cycle.[Official Report, 18 November 2002; Vol. 394, c. 388.]
	Is not the truth that he is trying to adjust the economic cycle to suit his fiscal policy? What does he say to the national institute, which said of his golden rule:
	XYou can already smell the fudge being cooked up in Great George Street?
	What of the Chancellor's sustainable investment rule? If he had not, Enron-style, put 100 billion of his liabilities off the balance sheet, public sector debt would already have reached the 40 per cent. limit in his own rule. Will he confirm that the extra borrowing he has announced today takes us over that limit? Is not a black hole now emerging in the public accountsa hole entirely of the making of this Chancellor of the Exchequer?
	As we have constantly pointed out, the growth of public spending under the present Government is far faster than the growth in the economy. Is not the heart of the problem that the Chancellor is following his present course because without reform, his spending is not leading to the improvements to the public services that we all want? His only answer now is to spend more. How far he has come from his view in 1997, when Labour's manifesto stated:
	XThe level of public spending is no longer the best measure of the effectiveness of government.
	By spending more without reform, he has locked himself on an unsustainable course, and if spending keeps rising faster than the growth rate of the economy, he will have to put up taxes again.
	There were, as usual, plenty of promises on the public services in the Chancellor's statement, but every year he makes those promises and every year he breaks them. The Government are already taking almost 40 a week more in tax for every man, woman and child in the country. Yet while spending is indeed up on the NHS, patients are waiting longer in accident and emergency departments, and now, for the first time, there are more bureaucrats than beds. Although spending on law and order is up, crime and the fear of crime are on the increasestreet crime has gone up by 31 per cent. in the past year. Although spending is indeed up on education, we were told yesterday that reading standards in our primary schools have actually declined in the past two years, and one in every four children leaves primary school unable to read, to write or to count properly. In fact, the Government have failed or are failing 40 per cent. of the targets that the Chancellor set in 1998, and 75 per cent. of those he set two years later. Every year he makes those promises and every year he breaks them.
	We shall study with care what the Chancellor said about pensions, but it is a great pity that he did not answer the questions which my right hon. Friend the Leader of the Opposition put to the Prime Minister, but which the Prime Minister was so palpably unable to answer. Why does the Chancellor not start by getting the basics rightby encouraging people to save for their pensions, rather than discouraging them? How has his 5 billion a year pensions tax helped those who want to save for their retirement?

Ronnie Campbell: Pay for the rich and the gap will get bigger.

Michael Howard: Will the Chancellor say also whether any provision has been made for[Interruption.]

Mr. Speaker: Order. Mr. Campbell, please be quiet.

Michael Howard: Will the Chancellor say what provision he has made for public sector pay rises? Is it not the case that the Government have been in a complete mess and muddle on that issue, with the Chancellor, the Deputy Prime Minister and other Ministers all contradicting each other by the hour? This week, the Prime Minister entered the fray. On Monday, he was indulging his thespian fantasies, trying to play Margaret Thatcher. Well, I know Margaret Thatcher, and this Prime Minister is no Margaret Thatcher. [Hon. Members: XHear, hear!]
	In the statement, where was the announcement of action to reduce the burdens on business that the Government have imposed? Are not those burdens stifling the wealth creation on which we all depend? Does not yesterday's news that business investment has suffered the sharpest fall for 35 yearsa fall significantly greater than that in Germany or the United Statesrepresent a devastating vote of no confidence in the Chancellor and his policies?
	What does the Chancellor have to say about the causes for concern in the UK economy, such as savings? We are now saving less than we have practically ever saved before. Borrowing is at record levels, and house prices are rising at an unsustainable rate. The newly appointed Governor of the Bank of England is now warning of the risk of a large negative demand shock at some point in the future. There are concerns about the world scoreboard of competitiveness, where we have been relegated from the top 10; about productivity growth, which has halved; about business investment, which has now fallen for seven quarters in a row; about the trade deficit, which we have run nearly every single month for five years; about manufacturing, where 15,000 jobs were lost in September alone and half a million since Labour came to office; and about the stock market, which has fallen disproportionately in comparison with the United States, hitting people with savings, pensions and mortgages. Does the Chancellor agree with The Independent, which said last week that he should face up to the severe imbalances in the economy? We have seen no sign of that today.
	This is a Chancellor who clung like King Canute to his economic forecasts in the face of all the evidence. Today's statement shows him to have been wrong on all counts. His fiscal rules are not as rigorous as he claimed, and he has missed the very targets that he described as cautious and prudent. How mortifying that he, of all Chancellors, should have got it so badly wrong. On top of all that, we have still not seen the improvements in public services that he promised. Has not the time come for an end to the policy of taxing and spending and failing? Does the Chancellor not think that the people of this country deserve better?

Gordon Brown: The shadow Chancellor is making exactly the same economic policy mistakes as those made by the Conservative Government and every previous shadow Chancellor. He said that our spending is unsustainable and tried to say that the national insurance tax rise should not go ahead. He refuses to match our spending on the public services, but his solution is to cut spending this year, next year and in future years. Cutting spending during a world downturn would depress demand, put up unemployment and put stability at risk. His colleagues have said that he would continue to spend on the Home Office and on defence, so the major spending cuts that he proposed would hit the health service and education. He must tell us which schools and hospitals, and how many teachers, nurses and doctors would lose out as a result. Like his party, he is making exactly the same economic policy mistakes that the Conservatives made in the early 1990s.
	We will take no lectures from a shadow Chancellor who was Employment Secretary in the early 1990s. Inflation is 2 per cent. in this country, but under him, it was 10 per cent. Interest rates are 4 per cent., but under him, they were 15 per cent. The deficit is 1 per cent., but under him it was 8 per cent. Unemployment is below 1 million but, worst of all, during his term as Employment Secretary, it was above 2 million. We will therefore take no lectures from the Conservative party.
	It is not only me who is criticising the shadow Chancellor's record, but the current leader of the Conservative party. In The Sunday Telegraph, 6 October 2002, the leader of the Conservative party talked about the economic mistakes of the shadow Chancellor when in government in the 1990s. XBusinesses, he said,
	Xwent to the wall. We broke our pledge on taxes, there was negative equity in homes.
	This is the current leader of the Conservative party talking about the work of the current shadow Chancellor. He continued:
	XThe public felt hurt. Then we lectured them, and we seemed arrogant.
	[Interruption.]
	The Opposition do not like it because it is true.

Mr. Speaker: Order. I do not like it either. The Chancellor must answer the questions that he was asked[Interruption.] Order. Divisions within the Conservative party are nothing to do with me and nothing to do with the Chancellor in the Chamber.

Gordon Brown: When the shadow Chancellor refers to his record in the early 1990s, let us look at what he is proposing today. First, on[Interruption.]

Hon. Members: Sit down.

Mr. Speaker: Order. I have called the Chancellor back to the Dispatch Box. There is only one Speaker in the Chamber.

Gordon Brown: First of all, the right hon. and learned Gentleman says that we should not have gone ahead with the ACT dividend tax credit. Let me remind the Conservative party that it cut it by half during its period in office. Then he said that we should be concerned about burdens on business. I have the report of the World Economic Forum from which he was quoting. It says that the improvement in the UK's position is particularly remarkable with its jump from seventh to third this year. It is the Conservatives who must look at their record on regulation.
	As for the burden on small business, we are removing the burden on small businesses of having to account for every item of VAT. We are removing the audit requirement, and the right hon. and learned Gentleman should have noticed in the pre-Budget report the consultation that is now being carried out on all the other items.
	On the question of public services, which the right hon. and learned Gentleman also raised, does he not know that literacy and numeracy results, A-level results and the numbers of people who are able to go to university are the best that have been recorded in this country?
	As for the right hon. and learned Gentleman's other points[Hon. Members: XMore, more.] As for his other points[Interruption.]

Mr. Speaker: Order. We must have order in the House.

Gordon Brown: As for the right hon. and learned Gentleman's other points about manufacturing, it is growing in the third quarter of this year and business investment is 25 per cent. up on 1997, but we are facing exactly the same problems that businesses are facing around the world.
	As for the right hon. and learned Gentleman's further point on crime, he should recognise that crime is down under this Government. As for his point on savings ratios, he should understand that we have the lowest savings ratio[Hon. Members: XYes.] The lowest savings ratio was recorded in 1988, under the last Conservative Government.
	As for the right hon. and learned Gentleman's points about the downturn in world activity, let me point out to him that in 1991, the world economy was growing by 0.9 per cent. in the G7 countries and in 2001, unfortunately, it was growing by 0.6 per cent. That is the pointin far worse world conditions, Britain was first in and last out in the last recession. It is now growing and has a stable economy, and we can meet our public spending plans and have the lowest inflation and interest rates for 25 years and the lowest unemployment. That is a record that Labour Members are proud of.

Matthew Taylor: At least the Chancellor, unlike the Conservative party, knows how much he wants to tax and spend. The problem for him is that he is running out of money and ideas. It is noticeable that while he used to claim credit for everything that was going right, he now ducks any blame for anything that is going wrong.
	The announcement made today involved the Chancellor in doubling borrowing to more than 100 billion over the next five years, compared to his plans in the Budget. His borrowing to cover a short-term problem is one thingthe right response to a temporary setbackbut his Budget will go bust in the long term unless he tackles the collapse in British industry and stops relying on an unsustainable boom in consumer debt to keep his growth figures up.
	Does the Chancellor even recognise that UK business investment has now crashed faster than in Japan, the United States, France, Italy and even, on the latest figures, Germany? It has crashed faster than at any time since records began and his latest figures today predict that it will stay lower. Even the Government's own investment in schools and hospitals is 25 per cent. below the level that they planned.
	Those are not world problems. Does he know that our share of inward investment into Europe has collapsed from 28 per cent. to only 16 per cent. in a mere four years? Those are not the problems of the world economy.
	Is the Chancellor proud of a manufacturing recession that is the deepest since 1981 and the longest since 1945? Is he proud of the fact that 500,000 people have lost manufacturing jobs in this country when such employment has increased in the European Union? Those are not world problems.
	Is it not true that record household debt is the only reason that UK growth has held up? Does the Chancellor agree with the Bank of England that increasing debt and booming house prices are not sustainable? They are not the basis for sustainable long-term plans for investment in education and health.
	Today, the Chancellor has again provided further tax complication and red tape for business. He has no new ideas for tackling the exchange rate problem that British business faces, the recession in manufacturing and the collapse of investment in this country that is far greater than that of our competitors.
	What exactly is the Chancellor's assessment of the additional risk from any war with Iraq? He said that he would have to make such an assessment. We are not simply considering a world downturn. The scale of our manufacturing problems is unique to Britain and it has been engineered in 11 Downing street by meddling, red tape, tax complication and a lack of action on the exchange rate.
	Unlike the Conservatives, we do not believe that the Government should cut education and health spending. [Interruption.] The Conservative party does not believe in anything. It has no policy on tax or on spending. Indeed, it has no policies at all, so we will take no nonsense from Conservative Members.
	The Chancellor needs to mend his ways and stop passing the buck. He must cut red tape and simplify the tax system. He has to tackle the exchange rate issue or devise an alternative solution. If he does not, his long-term plans for investment in health and education cannot be realised. He risks that today with his complacent approach of refusing to accept that a single problem in the British economy can be laid at his door.

Gordon Brown: I am grateful to the hon. Gentleman for asking about the direction and balance of the economy. However, he must bear it in mind that our economy is stable and growing, while other economies have been in recession. He cannot claim that manufacturing job losses have not hit the German, French, Italian and other economies in Europe. Unemployment in Germany has again increased beyond 4 million, and the German economy is barely growing.
	The hon. Gentleman cannot disguise the fact that the slowdown and contraction of industrial activity have been happening throughout the G7 countries. A feature of that is the IT slowdown that has occurred in America and Japan as well as in Europe. That is a major reason for our difficulties because business investment in IT was a critical factor in the late 1990s. He cannot therefore ignore the world factors and the global restructuring of industrial activity.
	On the balance of the UK economy, as I said earlier, we expect industrial production and manufacturing output to increase and business investment to recover next year when the housing market slows down and the pace of consumer demand is sustainable. However, I remind the hon. Gentleman that business investment is 25 per cent. higher than in 1997, and that it increased from 11 per cent. to 14 per cent. of GDP. That was partly because we changed the dividend tax credit, cut corporation tax and rewarded corporations for their investments.
	The hon. Gentleman complained about the domestic balance of the British economy. We are taking steps to consult about more investment incentives for business. We shall continue to do that, and he should support us.

John McFall: I associate myself with the Chancellor's congratulations to Sir Edward George, the Governor of the Bank of England, on his wise stewardship of the Bank and the Monetary Policy Committee over the years. I also welcome his worthy successor, Mervyn King.
	We accept that this country cannot escape the consequences of a downturn in a global economy. My right hon. Friend should not listen to the Jeremiahs in the Conservative party. The shadow Chancellor not only knew Margaret Thatcher, but, like a lap dog, implemented her disastrous policies. May I suggest that the Chancellor stands fast on the macro-economic objectives that have provided high employment, low mortgage rates, a stable environment and, more than anything, have utilised the previously unused talents of young people?

Gordon Brown: I agree about using the talents of young people. I hope that my hon. Friend will welcome the work that we are doing, especially my right hon. Friend the Secretary of State for Education and Skills, on modern apprenticeships and training, not just college and university training, but industrial and workplace training for young people.
	On the monetary and fiscal rules, I hope that hon. Members in all parts of the House will agree that the monetary and fiscal rules that were established after 1997rules that apply over the cycle, but rules that are disciplined and which must be metare the best rules for the British economy. I hope that the House will agree that by keeping to those rules, not only shall we establish credibility, but we shall be able to keep interest rates lower than they would otherwise be.

Kenneth Clarke: I add my congratulations to Sir Eddie George and welcome the appointment of Mervyn King.
	Will the Chancellor stop pretending that his present situation is the result of some careful Keynesian counter-cyclical planning on his part, when in fact he has come to the House to talk his way through the collapse of those absurd forecasts that he gave us only six months ago, at the time of his Budget? When he looks back, as he keeps doing, will he realise that he runs the risk of adding his name to the list of Chancellors who, first of all, gave way to political pressure to increase public spending, then claimed that it would all be affordable by making ridiculous estimates of future growth of the economy, then pretended that there was no problem when unexpected borrowing suddenly surged, and claimed that that could all be accommodated, and then did nothing effective on fiscal policy until the problem turned into a crisis?
	The mistakes of which the Chancellor speaks are the mistakes made by Chancellors in the 1960s, the 1970s and the 1980s, and not repeated by the Major Government, which is why he inherited a stable economy already achieving growth with low inflation. That economy is now being sustained by a housing boom, household debt and public spending at an unsustainable rate. Will he come back to the House, recognising the existence of the problems to which he pretends to be blind, and present some substantial measures that might tackle them and restore stability to the British economy?

Gordon Brown: I am always interested to hear the words of the former Chancellor, but they would carry more weight if he had not left debt at 44 per cent. of GDP and forced us to cut it, and if he had not left an inflationary problem that had to be dealt with by raising interest rates in the first days after we came into government. I must therefore look at his record in the context of high debt, his failure to make the Bank of England independent, and the high inflation that he left us. [Interruption.] That rising inflation had to be met by rising interest rates when we came into government.
	On the right hon. and learned Gentleman's comments about forecasts, our forecast was 2 to 2.5 per cent. The eventual outcome that we are forecasting now is 1.6 per cent. That is a long way from Conservative Governments in the early 1990s saying that there was no recession, when there was a recession.

Martin O'Neill: I congratulate my right hon. Friend on his statement. Many of us who have been in the House for a wee while remember the conditions in which other economic difficulties were confronted by Governments. Given the present state of our economy and the health of our public finances, we do not need to take any lectures from the Opposition. However, I point out to my right hon. Friend that manufacturing industry looks for more assistance than it has received this afternoon. I should like to think that by the time of the Budget we will have had a proper review of the climate change levy, and I look towards an indication of a more rational form of carbon taxation in relation to energy. Finally, will my right hon. Friend try and hurry up some of the officials in his Department so that they complete the long-awaited review of the taxation of foreign nationals in this country?

Gordon Brown: I am grateful to my hon. Friend. The review on foreign nationals is continuing and we shall publish the documentation later.
	On my hon. Friend's main points about manufacturingI understand his long-term interest in the matter as Chairman of the Select Committee on Trade and Industry, and his constituency interest as wellthe measures that we have taken include a research and development tax credit to help future manufacturing, 100 per cent. capital allowances, and venture capital funds in the regions, which are of assistance to manufacturing and therefore to investment. The main contribution that we can make with regard to the costs of investment for industry is to keep interest rates and inflation low.
	The issue for us is not that we stand by and do nothing when manufacturing is in difficulty; we have done what we can in terms of capital allowances and investment allowances, and of providing a stable macro-economic environment to help manufacturing industry. Of course, the changes in manufacturing industry are taking place right across the industrial world. So far as the climate change levy is concerned, we froze it this year.

Michael Fallon: The Chancellor announced the endorsement of his pre-Budget assumptions by the Comptroller and Auditor General. Will he confirm that this is the same Comptroller and Auditor General who threw out his claim that Network Rail was a private sector company? Is it not typically disingenuous of the right hon. Gentleman to take credit for the former but to take no account of the latter?

Gordon Brown: The Office for National Statistics

Michael Fallon: The Auditor General.

Gordon Brown: Yes, but the Office for National Statistics makes the recommendations about off and on-balance-sheet matters. We have operated in exactly the same way as the previous Conservative Government did. If the shadow Chancellor is accusing us of Enron-style activity, which is a suggestion of corruption rather than of getting things wrong[Interruption.] He is saying that Enron is not an example in which corruption was involved. If he is accusing us of such activity, he must also accuse his own Government, because we are operating under exactly the same rules. With regard to Network Railthe case in point regarding the National Audit Officewe rigorously pursued the recommendations of the Office for National Statistics. Those are the same as the recommendations of the EUROSTAT office, and we have acted in accordance with all those rules. The same rules applied under the last Government.

Tam Dalyell: The Chancellor will hardly be astonished if I press him on what he said in his opening statement about the unfolding events in Iraq. What exactly are the assumptions about oil prices? Will he also clarify the reference that he made towards the end of his statement to 1 billion for terrorist contingencies? Is that supposed to cover a military operation against Iraq? Are there not two jokers in this pack? The lesser may be the cost of the war; the greater will be the consequence for oil prices of the middle east going up in flames. It would be sheer follyin terms of all sorts of things, not least the economyto set the middle east on fire.

Gordon Brown: The setting aside of 1 billion in the reserve is in line with previous practice, and it is to deal with eventualities if or when they arise. I know that my hon. Friend takes a detailed interest in what is happening in the middle east. As he will know, oil prices have risen partly as a result of the uncertainty. They rose quite high, then they came down a bit. A great deal of the activity surrounding oil prices is related to that uncertainty. Our assessments of what oil prices are likely to be are independently audited by the National Audit Office. The price that we assume for oil tax revenues, for example, as well as for economic activity, is the one that is audited by the NAO. I will send my hon. Friend details of that.

Peter Tapsell: Does the Chancellor deny that, at the time of his Budget last April, many Conservative Members told him that his growth forecasts were over-optimistic and unreliable? Does he also deny that we have been proved right, and that he has been proved wrong? Why should we now believe his projections for future years? Is it not the case that he has now reverted to his political ancestry of spend, tax and borrow, that he is frantically trying to weaken the European stability pact, and that he has thrown away his capacity to dominate monetary policy? In these circumstances, would it be helpful if I sent him an e-mail giving him an up-to-date telephone number on which he can get in touch with the International Monetary Fund?

Gordon Brown: I thought that the hon. Gentleman was one of the few Keynesians left on the Conservative Benches. Clearly that is not the role that he is playing today. So far as the changes since the Budget in April are concerned, I think that he would agree with me that a stock market fall of 25 per cent. in Britain, and a 40 per cent. fall in France and Germany, are significant events that not even he, with his prescience, could have predicted in April. He must realise that those events have a bearing not only on the value[Interruption.] The shadow Chancellor says that the hon. Gentleman did predict this; I would be very surprised if he had actually done so in practice.
	A 25 per cent. stock market devaluation must be taken into account in our calculations of corporate tax, capital gains tax, stamp duty and other matters. That is one change that has taken place since April. On other changes since April, I do not think that the hon. Gentleman would have seen the German forecast at that time. Germany was forecasting far higher growth, but growth is now only 0.4 per cent.

Mark Hendrick: I commend my right hon. Friend's plans to devolve the training and skills budget down to regional level, which will be welcomed in the north-west. I also commend his plans to ensure that a third of young people go into modern apprenticeships. May I bring to his attention the excellent schemes going ahead at the BAE Systems training plant in Preston whereby 300 young apprentices are getting excellent apprenticeships, which have recently received an award for excellence? That can act as a model for training and apprenticeships throughout the north-west.

Gordon Brown: I am grateful to my hon. Friend. I know that he takes an interest in the BAE development and the work being done on industrial training. Apprenticeships were virtually dead a few years ago, but there are now 200,000 modern apprenticeships, and that number will continue to rise to 300,000. We believe that it can rise substantially further, but we need to invest in modern apprenticeships and we need to encourage small firms in particular to take an interest. That is the purpose of the modern apprenticeships taskforce, which I hope will have a regional representation, which he seeks.

David Trimble: Among the papers published by the Chancellor today is one on protecting indirect tax revenues. I welcome the fact that it includes detailed information on the extent of oil fraud in Northern Ireland, and I hope that it conveys to Members and the general public here the extent of the revenue loss, which is given as 370 million in 2001.
	I draw the Chancellor's attention to the Northern Ireland Affairs Committee report published today, entitled XThe Impact in Northern Ireland of Cross-Border Road Fuel Price Differentials. Will he look carefully at the report and, in particular, consider the fact that it urges the Government to study and
	Ximplement a separate lower rate of fuel . . . duty in Northern Ireland, by derogation if necessary?
	Will he consider also corporation tax rates and the significant cross-border differential between Northern Ireland and the Republic of Ireland, which has a distorting effect on investment in Northern Ireland and limits significantly our ability to attract inward investment?

Gordon Brown: I am grateful to the right hon. Gentleman. We have discussed that a number of times, and he kindly brought a delegation to see me and other Ministers on the matter. We understand the scale of the problems of oil fraud in Northern Ireland, cross-border fraud and trafficking, which is why the report has been published today. I look forward to discussing with him what it says and what we can do to take things forward. We share his aim of reducing the revenues that are lost and we are looking for solutions, which we shall discuss with him and the Northern Ireland Administration, once re-established.
	On the question of corporation tax relief, I visited Northern Ireland with the Prime Minister and we made a number of proposals to inject additional resources into the Northern Ireland economy. We recognise that there is a long way to go for business to grasp the opportunities that are potentially available, but we shall continue to do what we can. The right hon. Gentleman should consider some of our proposalsfor example, the extension of the business loan guarantee schemeand I look forward to talking to him again about how we can help to expand take-up of some of those schemes in Northern Ireland.

George Mudie: I congratulate the Chancellor on the pension credit. He knows that the minimum income guarantee was much resented by those who had worked hard but received only a small pension that took them above pension credit level. Therefore, they did not get the benefit.
	I should like to do the shadow Chancellor's job on that issue, because strangely he left the figures alone. I must press my right hon. Friend on the figures in his speech, because they are too good to be true. I seemed to catch him saying that 5 million peoplealmost half the pensioners in the landwill get about 2 billion between them under that benefit. Why did the shadow Chancellor leave those figures aloneout of generosity to my right hon. Friend or because my right hon. Friend deserves double congratulations on those acts?

Gordon Brown: I am grateful to my hon. Friend for mentioning the importance of the pension credit. The figures are indeed accurate. We shall ensure that pensioners throughout the country are aware of the benefits available to them, just as we shall make people aware of the child tax credit. I believe that the take-up will be high once people realise the benefits that will flow from this measure. The figure is indeed large5 million pensioners.
	I agree with my hon. Friend about the minimum income guarantee for pensioners, but our first job was to ensure that we did all that we could to eliminate or reduce pensioner poverty. That is why we tried to lift the poorest pensioners, particularly widows in their 80s or over, out of the income support system that existed under the previous Government, with a far higher minimum income guarantee. I am pleased that it is now 102; it has risen by 30 per cent. in real terms since we came into office.
	We can now build further. This measure rewards savingsthe works pensions and the modest savings that people have. Given that 7,000 households will benefit from the measure, I am sure that hon. Members will want to make all those pensioners who can benefit aware of it.

Nicholas Winterton: I compliment the Chancellor on his robust presentation. However, he would expect me to say that I am rather suspicious of its content. He failed to respond properly to the question put by his hon. Friend who chairs the Trade and Industry Committee, the hon. Member for Ochil (Mr. O'Neill), about the impact of Government policy on manufacturing industry in particular. The hon. Gentleman also mentioned the climate change levy, which damages industry even if it might assist banks, insurance companies and building societies.
	Will the Chancellor direct his attention at the red tape, bureaucracy and regulation that he has imposed on British manufacturing industry, because it is making matters harder and harder? He will appreciate my lifelong commitment in this place to manufacturing industry. The Confederation of British Industry, the chambers of commerce and the Institute of Directors are not enamoured with much of what he has done.

Gordon Brown: I am grateful for the first set of remarks from the hon. Gentleman. He is indeed a supporter and defender of manufacturing industry, and throughout the time in which we have been in the House together, he has spoken up for the needs of manufacturing.
	The hon. Gentleman must remember that the climate change levy was a revenue-neutral measure as far as business was concerned. We froze the levy this year. We want to meet our environmental commitments nationally and internationally in the long term.
	On business taxes, as the hon. Gentleman should know, we reduced corporation tax from 33p to 30p. Small businesses will benefit from that even more this year, with the 19 per cent. rate and the 10 per cent. rate abolished so that the first 10,000 of profit are exempt from tax, so we are doing our best to encourage small businesses.
	On manufacturing industry, the research and development credit has been widely welcomed. Equally, the measures that we announced today to expand the advisory service for manufacturing industry in every region, are welcomed too. The hon. Gentleman knows that what manufacturing industry wants most are favourable trading conditions, low interest rates and low inflation. We have low inflation and low interest rates; we want to create favourable trading conditions for that industry.

Tom Clarke: Does my right hon. Friend accept that the Government's achievements and objectives in international development are outstanding in every sense? Could that be why the shadow Chancellor and the former Chancellor, the right hon. and learned Member for Rushcliffe (Mr. Clarke), did not say a word about the Government's policies?
	Will my right hon. Friend, based on his successes and those of my right hon. Friend the Secretary of State for International Development, continue with those policies, particularly in debt relief, humanitarian aid and fair trading? Will they find themselves in a position, if not today then later, to tell us when we might achieve the United Nations targets?

Gordon Brown: I am grateful to my right hon. Friend. He has been a lifelong proponent of greater aid and investment in the poorest countries of the world so that we can tackle their poverty. The whole House knows his contribution.
	I believe that we can have the support of all parties in the House for the policies that we are now pursuing, and I appreciate the fact that all Opposition parties have said that they wish to support that initiative. Our aim is 0.7 per cent. The initial measures that we are putting forward for a 50 billion increase to 100 billion of development aid by the developed world involves a compact whereby, in return for the developed countries insisting on corruption-free policies for stability, better conditions for trade, which require the Doha talks to have been successful, and a more conducive environment for investment, we should in return be prepared to put in the additional development aid. That is why we are proposing the new international finance facility. I believe that the response from other countries will encourage us to move ahead. I chose to end the pre-Budget statement with international development aid. If we are to tackle the insecurities and inequalities of globalisation, we as developed nations will have to do far more.

Michael Spicer: Why has the enterprise culture, which the Chancellor inherited, been replaced by one that is dominated by trade union activity, regulations and high taxation, and why in particular has investment collapsed?

Gordon Brown: The enterprise culture is being encouraged in the schools with the measures that we are putting forward today, in high unemployment communities with the 2,000 new enterprise communities, in our work with Young Enterprise, the inner city 100 and all the enterprise agencies, which we have tried to encourage over the past few years. The hon. Gentleman should recognise that, if an enterprise culture can be built in each region and in each community, from the school classroom to the boardroom, it can make a huge difference to the chances of creating businesses and jobs. I should have thought that he would have been at one with us on that.

Nigel Beard: I congratulate my right hon. Friend on the robust strength of the economy, despite the uncertainties and difficulties in the rest of the world. What steps have been taken to encourage business investment and innovation, particularly in manufacturing industry?

Gordon Brown: I am grateful to my hon. Friend, who is a member of the Treasury Committee and is extremely interested in that matter. As he knows, the main measures that have been taken over the past few years are the research and development tax credit and the raising of capital allowances for small and medium businesses, but in addition the creation of regional venture capital funds, where the European Union has given approval to go ahead, provides additional funds that are put at the service of business. The university challenge fund and the higher education innovation fund are a means by which to link ideas coming out of universities to the creation of new businesses. In each region, we can see more opportunities for business to benefit from new ideas and new insights. If we are to win in respect of the high value-added, technology-driven products of the future, it must be part of the Government's job to encourage science, innovation and research, and to put that more at the service of successful businesses.

Alex Salmond: The Chancellor knows that he will get support from these Benches on international aid initiatives, but can he confirm that his growth forecasts are down, his borrowing forecasts are up, he has created a bust out of boom in the oil industry and is now trying to repair the damage, and he has scuppered a settlement in the firefighters' dispute because of pressure on the public finances? Given that for five years in a benign international environment he claimed the credit for every single success, is there any measureeven onethat, on reflection, he will want to point to that may have contributed to him being blown off course?

Gordon Brown: On the oil industry, we were right to raise the supplementary corporation tax for an industry that had made very substantial profits, but in return for that we increased investment allowances to 100 per cent. and we have now abolished North sea royalties. The hon. Gentleman's political party opposes the tax rise for North sea oil but has no means of raising revenues for the measures that it is proposing in every other sector. On the economy, I think that he would agree that the Scottish National party could never deliver low inflation, low interest rates, high employment, stable growth and continuing investment in public services.

Alan Simpson: I congratulate the Chancellor on being open about the downturn in the global economy and the dangers of accelerating the problems were we to cut public spending. I come back to some of the key points in his statement. There are dangers in cutting benefits to the young unemployed who are most marginalizedit is more likely to turn them towards drugs and crime than jobs and prospects. The schemes that have worked have stuck with the most marginalised long term, rather than sought to penalise them short term.
	For the past 20 years, the problem for public services has been the absence of real structural investment, rather than a shortage of private tendering. We must be careful about going down that path, and trying to sell to the electorate the virtues of a tax credit in exchange for a pay cut. In relation to the 20 billion of borrowing

Madam Deputy Speaker: Order. The hon. Gentleman must conclude his remarks.

Gordon Brown: Long-term youth unemployment reached nearly 500,000 at one stage in the 1980s, but is now around 5,000. My hon. Friend will acknowledge that that is a singular achievement, which was made by giving young people rights, responsibilities and opportunities. Those opportunities involved a lot of expense in training and advisory services, and young people had an obligation to take them up. I hope that my hon. Friend will agree that that is the right way to proceed.
	My hon. Friend the Member for Nottingham, South is right to say in connection with the PFI that there has been a low level of public investment in our vital public services. We are trying to correct that. However, the need to ensure better value for money and more investment in the short term in our hospitals and schools has required us to use the private finance initiative.

John Maples: According to figures from the House of Commons Library, the tax burden next year will be 153,000 million more than it was when Labour came to power. If my calculations are right, that means that on average every man, woman and child in the country will pay 2,600 a year more in tax. Are those figures correct?

Gordon Brown: The figures that we are publishing today show that the tax burden is 37.1 per cent. of national income, which compares with the peak under the Conservatives of 38.9 per cent.

Nick Palmer: The House will have enjoyed the shadow Chancellor's efforts at singing, and will wish him a great career on XPop Idol. He criticised my right hon. Friend the Chancellor for excessive public spending, but the Governor of the Bank of England told the Treasury Committee yesterday that the contribution of public spending to the economy at this point is very important to stability and growth in Britain. Does my right hon. Friend agree?

Gordon Brown: I am grateful to my hon. Friend for reminding us of that. Like the rest of us, the shadow Chancellor may wish to thank the Governor of the Bank of England for the work that he has done. However, the Governor pointed out yesterday that the best way forward for the economy is borrowing. That contrasts with the policy of cutting public spending put forward by the shadow Chancellor, who has absented himself from the House.

John Bercow: Why have the Government failed to meet 40 per cent. of the public service agreement targets set in 1998? Why does the Chancellor not recognise that, while failing to meet targets set by independent experts would be disappointing, failing to meet his own requires incompetence on a truly spectacular scale?

Gordon Brown: We met 87 per cent. of the targets in time. Subsequently, we have met another 6 per cent., which means that we have met 93 per cent. of our targets. The hon. Gentleman should congratulate us.

Several hon. Members: rose

Madam Deputy Speaker: Order. In the time remaining, I intend to try and call all hon. Members who want to contribute to the debate. However, I urge hon. Members to ask short questions and, perhaps, offer short answers.

David Taylor: In response to my hon. Friend the Member for Nottingham, South (Alan Simpson), my right hon. Friend the Chancellor mentioned the benefits of PFI. However, are they not rather short term and illusory? In the medium and long terms, will not PFI be shown to be prohibitive in cost, flawed in concept and intolerable in consequence for taxpayers, citizens and workers in our country? The figures that my right hon. Friend published in the House today show that public projects could be financed in a traditional way. We do not need the PFI. It does not wipe off figures from the public balance sheet.

Gordon Brown: My hon. Friend, who takes an interest in these matters, should look at some of the public sector projects undertaken without PFI projects. For example, the Jubilee line was two years late and 50 per cent. over budget. That was one example of the many public sector projects that did not work as well as they should have. The lesson that we learn is that it makes sense to use the private sector when one seeks to combine the transferred risk with management expertise in transport, infrastructure and the building of hospitals and schools. After all, private sector companies construct the buildings. The means by which we bind them in and ensure that the buildings are well constructed and managed is the means by which we have secured greater value for money in the public sector.

Michael Jack: With falling investment in both manufacturing and, equally worrying, the service sector, it is evident that a number of the fiscal measures enunciated by the Chancellor a few moments ago, which were said to benefit business, have not been working. May I inquire, in the interests of transparency, whether the Chancellor would be willing to ask the National Audit Office to evaluate the effect that his fiscal measures for business have had, so that we might at least on that occasion see the wood from the trees?

Gordon Brown: We are continuously evaluating the effect of our measures. That is what the pre-Budget and Budget processes are for. But is the right hon. Gentleman against the 30 per cent. corporation tax? Is he against the 3 per cent. cut that we introduced? Is he against the cut in small business tax from 23p to 19p? Is he against the capital gains tax cut from 40p in the pound to 10 per cent., which is helping many companies with business assets? Is he against those measures? [Hon. Members: XAnswer.] Well, if he thinks they should be evaluated he must have some doubts about their effectiveness. I believe we have proved that those are the right tax cuts for British business.

Alan Howarth: As he surveys the circumambient economic gloom, does my right hon. Friend share my relief that we in this country have been prudent enough not to go into the euro, and not to subject the United Kingdom economy to the deflationary pressures of the growth and stability pact? Does he endorse the calls made this week by the Governor of the Bank of England and the United States Treasury Secretary for the European Commission and the Eurozone countries to buck up, reform the system and make the contribution that they should make to economic growth?

Gordon Brown: My hon. Friend has strong views on these matters. I can remind him of what I said: the assessment of the euro will be made by June next year, and will take all such factors into account.

Tim Loughton: Earlier this week, the Chancellor berated the Confederation of British Industry and told it to stop whingeing about the likely impact of the extra 8 billion in national insurance contributions. He said that it was the CBI's duty to make its contribution to the NHS, because healthy workers helped their businesses. What has he to say to employers who already fund more than 2 million employees with private medical insurance, which in turn is contributing 390 million in benefit-in-kind taxation to his Exchequer this year? Is it right that they should suffer a double whammy, paying to keep people away from the NHS while at the same time paying tax in the form of additional national insurance payments?

Gordon Brown: But private insurance schemes need the national health servicefor accident and emergency treatment, for the training of doctors, for public health and for so many of employees' health needs.
	As for business costs in health care, in America many employees cost their employers about $100 a week in health insurance charges. In France the figure is about 60 a week, and in Germany it is about 30 a week. Those are the average social insurance costs. In every industrial country employers are paying in one way or another, while health care costs are going up. I believe that the national insurance charge for employers is less than anything being paid in France, Germany or America to cover employees for health insurance.

Tony McWalter: I welcome the Chancellor's statement, which I saw asin the words of the right hon. and learned Member for Rushcliffe (Mr. Clarke)a cunning Keynesian plot to counter the effects of the economic cycle. I admire my right hon. Friend's surefootedness in responding quickly to pressures on huge increases in companies' insurance costs, and look forward to learning the details; but may I contrast that with the absence of any comment on the crisis in university funding? If we do not act quickly, we will further erode the science base, to which my right hon. Friend made an important reference.

Gordon Brown: The inquiry into employers' liability insurance will go ahead under my right hon. Friend the Secretary of State for Work and Pensions. I recognise, as he does, the concern that is felt.
	As for universities' finance, under the spending review a considerable extra sum, about 1.25 billionsome in association with the Wellcome Trustis being put into science in the universities, and the rebuilding and modernising of the science base. And as for university funding in general, my hon. Friend may not know that in the spending review we allocated considerable sums to education. The specific allocation for universities will be made in due course.

Crispin Blunt: From 1 May 1997 until yesterday, the British stock market underperformed the American stock market by 30.24 per cent. Why?

Gordon Brown: The hon. Gentleman knows that the balance between the companies involved in the British stock market is quite different from the American stock market. Most of what has happened has been effect of what has been happening to the IT sector. The hon. Gentleman should also knowand this is in reply to the shadow Chancellor's pointthat since April there has been a 25 per cent. in the British stock market but a 40 per cent. fall in Germany and France.

Nick Gibb: The Chancellor gave a figure of 37 per cent. for the proportion of GDP taken in tax. Does expenditure on working families tax credit, which used to be called family credit, count as public spending, or does it reduce the figure? If it is the latter, does that not make nonsense of all the right hon. Gentleman's figures?

Gordon Brown: We use all the internationally agreed assumptions about this. The position adopted by the previous Conservative Government on mortgage tax relief was at odds with the international conventions. I have given a report on this matter to the Treasury Committee and I am happy to pass it to the hon. Gentleman.

Chris Grayling: Can the Chancellor rule out further rises in personal or business taxation during this Parliament?

Gordon Brown: We made our commitments in our manifesto at the general election that we would not raise the basic rate of tax or the top rate of tax, and we stand by those commitments.

Adam Price: The part of the Chancellor's statement dealing with public investment contained a tantalising reference to the importance of recognising the limits of markets in areas such as health care. Can the right hon. Gentleman tell us what he meant by that statement, and has he told the Secretary of State for Health or the Prime Minister?

Gordon Brown: We believe in the national health service, as I hope all right hon. and hon. Members do. That is what I mean about the limits of markets in health care.

Points of Order

Simon Thomas: On a point of order, Madam Deputy Speaker. We are shortly to discuss the Health (Wales) Bill, and the Order Paper says that the third report from the Welsh Affairs Committee and the Government's response thereto are relevant. I am sure that they are, but it is also relevant that the Bill has been subject to considerable pre-legislative scrutiny by the Welsh Grand Committee, which consists entirely of Welsh Members, whereas, in theory, members of the Welsh Affairs Committee may be from any part of the United Kingdom and not from Wales. If future Bills relating to Wales are subject to pre-legislative scrutiny by the Welsh Grand Committee, can that be referred to on the Order Paper? It is important that right hon. and hon. Members know that the Welsh Grand Committee plays an important role in the pre-legislative scrutiny of legislation that relates only to Wales.

Madam Deputy Speaker: The reference is usually to Select Committees, but if there has been an error on this occasion, the matter will be looked into.

Anne McIntosh: On a point of order, Madam Deputy Speaker. You will be aware of the need for Members of Parliament to respect each other's parliamentary boundaries. You will also be aware of XErskine May, page 123, which says that to intimidate a Member in his parliamentary duties by threats is a contempt. Mr. Speaker has been helpful

Madam Deputy Speaker: Order. I apologise for interrupting the hon. Lady, but this kind of complaint must be issued in writing, so it would be most helpful if she could do that.

Anne McIntosh: Further to that point of order, Madam Deputy Speaker.

Madam Deputy Speaker: Is it a different point of order?

Anne McIntosh: May I request that following the written response to the hon. Member for Harrogate and Knaresborough (Mr. Willis), the Speaker will take into account all instances going back to 1997?

Madam Deputy Speaker: I have no doubt that the Speaker will take the necessary steps when he responds to the hon. Member.

Orders of the Day

Health (Wales) Bill

[Relevant documents: The Third Report from the Welsh Affairs Committee, Session 2001/02, on The draft National Health Service (Wales) Bill, HC 959, and the Government's Response thereto, HC 1215, Session 2001/02.]
	Order for Second Reading read.

Peter Hain: I beg to move, That the Bill be now read a Second time.
	May I say what a pleasure it is having you in the Chair, Madam Deputy Speaker, as you are a Welsh girl yourself?
	The Health (Wales) Bill builds on the reforms introduced in the Government's National Health Service Reform and Health Care Professions Act 2002. In bringing it forward, the Government are supporting the efforts made by the Welsh Assembly to improve the health and well-being of the people of Wales and to strengthen patient power in the health service. It is the first Wales-only Bill to be brought before this House, fresh from and improved by the process of pre-legislative scrutiny carried out not just by Members of this House but by Welsh Assembly Members, as well as by health professionals and patients. As such, it is an historic measure that marks another chapter in the process of constitutional change initiated by the Government with the establishment of the National Assembly for Wales.
	The Bill achieves three purposes

Llew Smith: May I refer to a general issue that is not in the Bill but relates to the Secretary of State's comment that this is all about patient power? Is he willing to think back to the time when he and others were heading the referendum campaign for a Welsh Assembly? They were saying that, in order to have patient power, they would have a bonfire of the quangos. Can he tell me when that bonfire will happen, as I have not noticed it yet?

Peter Hain: My hon. Friend feels very strongly on these matters, as we all do. As he knows, a number of quangos have been abolished

Llew Smith: Will the Secretary of State give way?

Peter Hain: I will give way in a minute, but I want to answer my hon. Friend's point by explaining how the Bill achieves the purposes that I set outincluding a reference to independent public bodieswith which I do not think he would disagree.
	Let us consider, for example, the proposals, first, to establish an independent Wales Centre for Health to disseminate research and provide multi-disciplinary advice and evidence to support decision making, and, secondly to establish Health Professions Wales, a body to quality-assure the training and education of health care professionals. I am sure that my hon. Friend does not think that those two bodies should not be established. I am sure that he supports an independent Wales Centre for Health providing the necessary research into health needs in his constituency and mine. I am sure that he also agrees with Health Professions Wales, and that he does not think that quality assurance of the training and education of health care professionals should be conducted by a body other than one that has the confidence of those professionals.

Llew Smith: The Secretary of State referred to the abolition of many quangos. Will he accept that there are as many quangos in Wales now as there were when the Welsh Assembly was first set up? Will he also accept that, under the new proposals, there will be even more quangos in the health service than previously?

Peter Hain: I think that my hon. Friend will recall that, when there was tremendous public opposition to quangos in Wales, it was partly becauseI would argue that it was exclusively becausethey were packed with Conservative place people. Because of that, they were not accountable in any way.
	Two independent institutions will be established by the Bill. My hon. Friend has not told me yet whether he agrees with the establishment of a Wales Centre for Health or Health Professions Wales. I am sure that the whole House agrees with that, as all the pre-legislative procedures have endorsed precisely those new independent agencies, because they strengthen the health service in Wales and provide us with a platform for creating a genuinely world-class health service in Wales.
	The third purposeother than establishing an independent Wales Centre for Health, and the Health Professions Wales bodyis to reform and strengthen community health councils in Wales and establish a statutory association that will support community health councils and have a performance management role. I am pleased to say that the Bill implements a commitment made in our Welsh manifesto last year to reform the CHCs in Wales to strengthen their role as community watchdogs.

John Bercow: I congratulate the right hon. Gentleman on his appointment, and I have placed a bet on him to become a future leader of his partybut that is enough niceness for one day. Can he tell the House what is the total number of public service agreement targets set for the health service in Wales; how many have been met; how many have been missed; and what is he doing about the latter?

Peter Hain: I welcome the hon. Gentleman to the debate on Wales. He is an articulate parliamentary performer.

Nigel Evans: And he is on your campaign team.

Peter Hain: Indeed, he is on my campaign team. However, his bet is not very welcome, as I am happy doing this job and will do any other job that my right hon. Friend the Prime Minister would like me to do. The hon. Gentleman is a talented youngster, and it is a shame that the Conservative Front-Bench team is all the less talented for his absence. The Bill does not cover the specific matter that he raised.
	In our manifesto, we also pledged to build on the already successful legislative partnership with the Assembly and to continue to enact specific legislation for Wales where appropriate. That is precisely what the Bill does. It is yet another example of a Labour Government working in partnership with a Labour-led Assembly to deliver the means by which the national health service in Wales can be modernised and improved for the benefit of the people of Wales.

Simon Thomas: The Secretary of State visited the National Assembly on Monday or Tuesday and he heard the complaints from all parties about the narrow gap for Welsh legislation. He has just talked about partnership, but why can we get through only one Welsh Bill a Session? This Bill is the one for this Session. Will the right hon. Gentleman work harder to see whether he can widen the gap and will he work with institutions in this Parliament, such as the Welsh Grand Committee, so that we can fast-track legislation and create an even better partnership between the National Assembly and the House of Commons?

Peter Hain: We do not need to measure the extent of Welsh legislation by the number of Welsh-only Bills in the Queen's Speech. A whole number of pieces of legislation have Wales-specific clauses in themon planning, local government and several other matters. I am sure that the hon. Gentleman will welcome the Licensing Bill, which deals with the costly and mischievous referendums that are called even though Sunday drinking and Sunday licensing are widely supported across Wales. He is a diligent Back Bencher, so I urge him to look at the clauses in all the Bills that have been drafted at the request of the Assembly. With the support of my right hon. Friend the Secretary of State for Northern Ireland, who was the previous holder of my post, and the excellent assistance of my hon. Friend the Parliamentary Under-Secretary of State for Wales, they design into a raft of Bills coming before Parliament this Session provisions that cover the need that Wales has for Welsh-only clauses in general Bills that also apply to England. In this case, we have a Welsh-only Bill. I ask him to consider the facts rather than stick to the dogma.
	When we came to office, the health service was crying out for a programme of sustained investment. The hospital-building programme had almost ground to a halt, and nursing shortages had resulted from cuts in training in the mid-1990s. The budget recently published by the Assembly, which draws on resources made available by the outcome of the Government's spending review and confirmed by my right hon. Friend the Chancellor of the Exchequer this afternoon, will see the health budget in Wales rise next year to 3.8 billion. That is nearly 1,300 for every man, woman and child in Wales, and an increase of more than 70 per cent. since we came to power in 1997.
	The number of staff employed by NHS Wales has risen by more than 12 per cent. since 1997, and the Assembly has announced plans for 6,000 extra nurses, 700 more consultants and GPs and 2,000 more health care professionals over the coming years. During the last five years, the number of medical students in training has increased from about 970 to 1,104. By 2004in a couple of years' timethe number will have increased to 1,385. They are all important increases in staffing in the health service in Wales and compare with the background of Conservative rule when there were cuts, after cuts, after cuts.

Jon Owen Jones: Will my right hon. Friend acknowledge that, given the impressive list of inputs in the health service that he has mentioned, it is all the more important that we have a rigorous and independent audit structure so that we measure outputs and ensure that they are commensurate with the input that the management of our economy under a Labour Government has managed to provide for the health service?

Peter Hain: I very much agree, and the proposals provide for an independent inspection audit. I acknowledge my hon. Friend's contribution towards creating the foundations of the success on which the Assembly is now building when he was Minister for health in the then Welsh Office, succeeding another good Welsh health Minister, my hon. Friend the Member for Bridgend (Mr. Griffiths).
	The recent opening of the Swansea clinical school, the proposal for clinical schools in north Wales and at the Royal Gwent hospital, together with a graduate entry scheme to medicine also planned for Swansea, are significant stages in the Assembly's plans to increase the number of doctors in Wales. There are 700 specialist registrar training posts in Wales and there will be 60 extra posts by next year, with particular emphasis being placed on areas with shortages. We have also pioneered innovative ideas to improve services for the public. That includes NHS Direct Wales, a 24-hour helpline staffed by nurses which is available throughout Wales. It took nearly 239,000 calls in the 12 months to September 2002, an increase of more than 40 per cent. on the previous 12 months.
	The NHS in Wales is treating more patients than ever before, and I salute the dedication of NHS staff in Walesdoctors, nurses and many othersas they cope with the ever-increasing demand for treatment and care. After decades of underinvestment, there can be no quick fixes on waiting times. Significant progress has been made, however. The target to reduce waits for cardiac surgery to a maximum of 12 months has been met in full and the challenging target of reducing waits for orthopaedic surgery to a maximum of 18 months has been broadly met. The latter target is especially important for those of us who represent constituencies in Wales with a long legacy of industrial disease. The waiting lists for people who need hip or knee operations, for instance, are coming down, and they are on target to reduce even further.

Nigel Evans: The Secretary of State pays a glowing tribute to the reduction in waiting lists. In 1997, 378 people waited for more than 12 months for out-patient treatment. The figure for 2002 stands at 36,302. How does he account for that enormous increase?

Peter Hain: I do not gloss over the fact that the waiting list situation in Wales is not as good as it should be. The hon. Gentleman is right to draw attention to that. Two factors primarily account for the difference. The first is the increased demand for the use of the NHS in Wales. That is a sign of increasing excellence in our hospitals and health services in Wales. The second factor is best demonstrated by the example of turning an oil tanker around. That tanker was going in wrong direction under his Government, and it takes time to change its direction.
	Waiting lists for orthopaedics fell by more than 36 per cent. last month. That is good news for patients because most trusts in Wales now have no one waiting for more than 18 months for orthopaedic operations. Progress has also been made on cataract waiting times, with the number of people waiting for more than four months falling by more than 10 per cent. The waiting time target for cardiac surgery has been sustained with no patients waiting more than 12 months.
	The hon. Gentleman made an important point. One of the greatest health challenges facing the Assembly is the length of time that many patients have to wait to receive treatment or to see a consultant. We all recognise that too many people have to wait far too long. There are no quick fixes. The reasons behind that are complex. They relate to the legacy that we inherited from the hon. Gentleman's Government and to increasing demands on the system. There is no doubt, however, that substantial progress has been made, especially in the priority areas targeted by the Assembly. We are on target to improve the quality of health care in respect of waiting times and other matters.

Bill Wiggin: Does the Secretary of State agree that the level of funding for the NHS in Wales is already at a European level, where there are no waiting lists, and that the over-18-month waiting list has increased by more than 1,800 people since the pledge was made when the Assembly was established?

Peter Hain: I have partly answered that point. I do not think that we have yet reached European average levels. Getting there will take time, and the money to achieve that objective is being made available. Turning the NHS around from its state when we inherited it a little over five and a half years ago will be a long job.
	The difference between us is that we are willing to put in the investment while the Conservative party would cut that investment. Indeed, its Front-Bench spokesmen have repeatedly said that they oppose our public spending plans, and they have confirmed that this afternoon. We are able to maintain public investment at record levels and, in the health service, to increase it every year until 2008. Those are long-term plans enabling hospital managers, consultants, doctors and nurses to plan ahead. The quality of care, with the NHS treating more people all the time, is steadily going up.
	The NHS in Wales is treating more patients than ever before, and I salute the dedication of all its staff. In contrast to the Conservatives, who closed 17 hospitals between 1979 and 1997, we promised in our general election manifesto last year to open 10 new hospitals in Wales over 10 years. The latest steps in the capital programme were announced in the Assembly budget last month and include a replacement for the cottage hospital in Tenby and new community hospitals in Merthyr and in Ebbw Vale, in the constituency of my hon. Friend the Member for Blaenau Gwent (Llew Smith). I am sure that he endorses that decision by the Assembly, if few others.
	Both the Government at Westminster and the Welsh Assembly Government in Cardiff believe that the future of the health service in Wales depends on a process of investment and reform. That is why the Bill builds on the measures in the National Health Service Reform and Health Care Professions Act 2002 which remove an unnecessary tier of bureaucracy in the health service in Wales and introduce greater local accountability, placing local decision making in the hands of local communities, health professionals and patients. The proposals build on earlier restructuring by the Welsh Office, which reduced the number of NHS truststhey might be described as quangosfrom 26 to 15.
	The Assembly has been working hard to increase the responsiveness of the NHS to patients and the public and to strengthen the public's influence over the running of the health service. Proposals in the Bill will involve the people of Wales in their health service more fully than ever before. Already, strong relationships are being built between health and social care, and the Assembly has been at the forefront of bringing the patient's voice into decision making. The strengthening of that voice through the enhanced community health council structure, which is largely co-terminous with the local authority and local health board structures, will give the people of Wales an unparalleled, strong and meaningful local structure that will deliver for them, provided that the investment continues as we intend it should.

Alan Howarth: Does my right hon. Friend agree that the continuing existence of community health councils in Wales will be of great assistance to the new health boards, enabling them to fulfil their remit of developing health, social care and well-being strategies for their communities, thereby enabling Wales to make progress in preventive health care strategies? It will also enable the health service to play the part that it ought to play with the crime and disorder reduction partnerships. In those respects, Wales will be leading the United Kingdom.

Peter Hain: And not for the first time. I agree with my right hon. Friend that the retention of community health councils in Wales provides the bedrock for community involvement. Wales is leading England in that matter just as it is leading England by introducing free bus passes for pensioners and disabled people and by introducing Assembly learning grants, and so on.
	Further evidence of the importance of the reform process in Wales and of our commitment to ensure that the extra resources allocated to health in Wales are spent in the most effective way came with the welcome recent announcement by the Assembly Finance Minister, Edwina Hart, that Derek Wanless, who advised the Chancellor on the funding of the NHS at a UK level, has agreed to act as an advisor to a review of health and social care in Wales.

Simon Thomas: I thank the right hon. Gentleman for his generosity in giving way. He will recall that the Wanless report stated clearly that public investment in health care was the best and most effective and efficient way forward, and I am sure that he, like me, supports that. Will he therefore take this opportunity to support all those in the National Assembly who want to rule out the introduction of foundation hospitals in Wales?

Peter Hain: I welcome the hon. Gentleman's support for the stance adopted by Derek Wanless. It was on the back of his report to the Chancellor that we as a Government made a clear decision earlier this year that we would go for increased publicly funded health investment

Simon Thomas: We voted for it.

Peter Hain: It is good to know that, for once, the nationalists voted for a socialist measure. The more that happens, the better for usif not for them.
	Returning to the Wanless report and the application to Wales of foundation hospitals, the National Assembly has made it clear that it sees Wales' needs as being completely different from those elsewhere in the United Kingdom; therefore it will not introduce foundation hospitals. I support the National Assembly in that decision. That is precisely what devolution is aboutit was so that different decisions could be made according to different circumstances and different needs that we established the National Assembly for Wales, and a far better model for decision making it is than an independent Wales, which the hon. Gentleman's party supports. An independent Wales under the nationalistsMr. Speaker, I will not go too far down this roadwould be stricken with poverty, and there would be health service cuts as well as all the other difficulties that the nationalists would bring to Wales.
	The Wanless report that the Assembly will commission will both help to guide the reform and modernisation agenda for the NHS in Wales, and provide valuable evidence in allocating resources beyond the end of the next financial year. There are now clear dividing lines between the Government and the Opposition, between Labour and the Conservatives, on health. Labour stands for investment and reform, the Conservatives for cuts and privatisation. Earlier this year the Opposition voted against the Budget that released the extra resources that the Assembly is now investing in the health service in Wales. They toured the world in search of a policy on the health service, only to come up with the same old Conservative nostrums of privatisation, making patients pay for their own health care, and subsiding those who are able to pay for treatment.
	As for Plaid Cymru, it would not introduce the necessary reform and it could not afford the necessary investment. I make no apology for again asking the question that Plaid Cymru Members never want to answer: in an independent or self-governing Wales, how would they finance the record levels of public investment in the national health service that we are delivering? The answer is they would not, because an independent Wales could not.

Jackie Lawrence: Does my right hon. Friend agree that the nationalists have never satisfactorily answered this question about separatism: where would the money come from, bearing in mind that there is a significant difference between taxes raised in Wales and public spending in Walesa difference that could mean a 30 per cent. cut in public services, or a 50 per cent. tax increase?

Peter Hain: My hon. Friend makes a valid and wholly convincing argument. If the nationalists ever got their way, health services in Wales would be cut and hospitals would be closed, because they do not have the ability to finance the health investment that we are providing in record amounts, which the Bill is designed to underpin.
	Part of the Bill can be traced back to the policy document XBetter HealthBetter Wales issued by the Welsh Office in 1998, under the leadership of the then Welsh health Minister, my hon. Friend the Member for Bridgend (Mr. Griffiths), and to the Assembly's ambitious and wide-ranging national plan XImproving Health in WalesA Plan for the NHS with its partners, which was issued in 2001 and which set out a 10-year programme of renewal.
	Last year, we announced our intention to introduce legislation to reform the provision of health services in Wales by establishing local health boards, strategic health partnerships, the Wales Centre for Health and Health Professions Wales. I am pleased that we have been able to establish local health boards and strategic partnerships through the National Health Service Reform and Health Care Professions Act 2002, which went on the statute book on 25 June this year. That Act is important, as it provides the Assembly with a foundation on which to begin delivering the reform agenda that it and the Government want to carry through.
	However, we still needed to reform and strengthen community health councils and establish the Wales Centre for Health and Health Professions Wales. We therefore published the draft National Health Service (Wales) Billnow called the Health (Wales) Bill, which we are considering this eveningon 17 May this year, to include those remaining three elements. Publication of the draft Bill signalled the beginning of an intense three-part scrutinyby Parliament, the National Assembly for Wales and the public and those with a direct professional interest in the Bill. Pre-legislative scrutiny is an innovation introduced by the Government to elevate the quality of draft Bills, obtain greater involvement by people likely to be affected by proposed legislation, and improve the planning of the legislative process. The Health (Wales) Bill is one of the first measures to benefit from that innovation, and has been much improved and refined by the valuable contributions of a range of institutions, professional bodies and individuals. I pay special tribute to the Select Committee on Welsh Affairs and its Chairman, my hon. Friend the Member for Clwyd, South (Mr. Jones), for their contribution, and to hon. Members from all parties, but especially my own, representing Welsh constituencies.

Bill Wiggin: And me, I hope.

Peter Hain: I am not sure that the hon. Gentleman made a valuable contribution, but as I am a generous soul, I will take it on trust.
	So thorough was the process of refinement that not even the title of the Bill remained untouched. We therefore have before us today not the National Health Service (Wales) Bill but the Health (Wales) Bill. Pre-legislative scrutiny involved three parallel activities. Parliamentary scrutiny in the House was conducted by the Welsh Affairs Committee, and its report was debated by the Welsh Grand Committee. In the other place, Members were briefed on the Bill by both Government and Assembly Ministers and invited to register any concerns. The Assembly's Health and Social Services Committee undertook scrutiny of the draft Bill on behalf of the Assembly and there was also a public consultation.
	It is a testament to the robustness of the original policy that the draft Bill attracted widespread support. Indeed, the process of pre-legislative scrutiny revealed no significant concerns about the policy. In all, 45 recommendations for change to the draft Bill were madesome to remedy omissions, some to clarify the powers both of bodies dealt with in the Bill and the Welsh Assembly, and others to extend its scope. We decided to consider 17 recommendations further. In only one instance did we find that there were legal or technical reasons why it was not necessary or possible to amend the Bill as suggested. In the remaining 16 instances, it was appropriate to amend the draft Bill to achieve what was intended, and we did so.
	The changes have definitely improved the Bill. Some acknowledged omissions have been rectified and the powers and independence of community health councils, to which my right hon. Friend the Member for Newport, East (Alan Howarth) referred, the Wales Centre for Health and Health Professions Wales have been clarified. By retaining CHCs and making their membership a better reflection of the people whom they represent, by providing complaints advocacy services independent of the NHS in Wales, and by giving CHCs powers to inspect premises providing NHS services, we will build on the strong local relationships, which already exist within the health service in Wales. By establishing a statutory association of Welsh CHCs that will not only advise and assist CHCs but have a performance management role, we will guarantee the people of Wales a consistent service of the highest standard across Wales.
	By establishing the Wales Centre for Health as an independent body, we shall ensure that the people of Wales have the best multidisciplinary advice on health hazards, that risks to health are properly assessed and that research and other evidence is made available to support effective policy making and decision taking. By establishing Health Professions Wales as an Assembly-sponsored public body, we shall provide quality assurance for the training and education of those in the health care professions in Wales. Its remit will be extended to cover not just nurses, midwives and health visitors, but allied health professionals and clinical scientists.
	By 2004, there will be more than 4,300 nurses in training in Wales. That is more than double the number in 1997, when 2,029 were in training. The annual allied health professions training intake has been increased from 494 in 19992000 to 649 in 200102, and will have been increased by a further 681 by 200304. Among the increases in recent years, the occupational therapy intake has risen from 161 when we came to office in 1997 to 219 this year. In physiotherapy, there has been a rise from 168 in 1997, when the Conservatives left office, to 288 this year.

Elfyn Llwyd: The right hon. Gentleman is right to say that there has been an increase in the number of occupational therapists, but unfortunately, it is not sufficient. Will he please look again at the provision of bilingual occupational therapists, which is important in relation to speech therapy and so on? Furthermore, what will the Bill do about the dental crisis in Wales?

Peter Hain: I shall certainly look at the hon. Gentleman's question, because I agree that that is an important aspect of providing a high-quality health service for all the people of Wales.
	The Bill is designed to improve the health care targets and areas that it is explicitly set up to deal with. Health Professions Wales will set clear standards at an all-Wales level for the continuing personal and professional development of all sectors of the work force. The Bill will give the body a proper statutory footing. It is an enabling Bill that devolves powers to the Assembly to determine through its own secondary legislation the detail of the new arrangements. That is another example of the truism that the Assembly is a powerful body. It has enormous powers to influence and shape policies as it determines they should be for the needs of Wales.
	That is as it should be. The devolved Assembly will work in partnership with the health service in Wales and the people of Wales to determine what is right for Wales. That demonstrates once again that, through the devolution settlement, we can deliver policies adapted to the particular needs of Wales. The Bill follows previous legislation such as the Learning and Skills Act 2000, the Children's Commissioner for Wales Act 2001 and the National Health Service Reform and Health Care Professions Act 2002, all of which had specific Welsh clauses. It represents devolution in action and progress through partnership.

John Bercow: I am grateful to the Secretary of State for generously giving way again. Given that health inequalities are often income relatedto put it bluntly, poorer people are more likely to become and remain illwill he point to what provision there is in the Bill or will appear subsequently in secondary legislation to tackle that disturbing phenomenon?

Peter Hain: The hon. Gentleman is absolutely right that income inequalities are a tremendous source of health inequality and are a particular problem in Wales. In valley constituencies such as those that I and the Under-Secretary, my hon. Friend the Member for Islwyn (Mr. Touhig), represent, that is a curse and a legacy of our industrial history. On the help provided by the Bill, the Wales Centre for Health will ensure that those inequalities are monitored and that the policies that are designed by the Assembly and, where necessary, implemented through primary legislation here are tailored to deal with them. Health Professions Wales will also ensure that the professions in Wales are trained to a standard that is sufficiently high to address those inequalities.
	Before I gave way to the hon. Member for Buckingham (Mr. Bercow), I was about to say that I commend the Bill to the House.

Nigel Evans: The debate is important because it gives hon. Members an opportunity to discuss issues that relate to the national health service in Wales. Post-devolution, the ability to ask questions on health is somewhat constrained. That is a pity. Members of Parliament with an interest in Welsh affairs must be aghast at what the NHS has become for far too many people in Wales.
	I welcome the fact that the Bill was published in draft. As the Secretary of State said, many observations and comments were received before it appeared in its current form. I believe that we have fewer opportunities to debate issues fully now than when I was first elected 10 short years ago. Most of that change has occurred in the past five long years.
	The Bill is another stepping stone in the troubled waters of the NHS that leads to yet more change.
	XThe National Health Service is safe in our hands.
	XYou only have 24 hours to save the national health service.
	Those statements must ring loud and hollow in Wales. I have used the NHS in Wales. I lived in Swansea for 33 years; my brother worked as an electrician on Singleton hospital when it was built, and my other brother, Anthony, had an operation for cancer at that hospital in January 1998. I cannot pay great enough tribute to the staff at every level who gave my brother back his health. I pay tribute generally to the hard-working staff of the NHS. They work under enormous pressure and constant change.
	Our health service has genuine problems, despite the extra revenue that has been earmarked for the service and that the Secretary of State mentioned. Sadly, for far too many people, the extra expenditure is not reaching the right parts to ensure an improved service. Some of the biggest complainers about that miserable fact are those who work in the NHS.
	I want to make several points about improving the service for our patients. The retained community health councils, which the Bill covers, will want to consider many deficiencies. Do hon. Members remember the following pledges:
	XBy the end of a Labour Assembly's first term no one will wait more than 18 months for inpatient treatment;
	XBy the end of a Labour Assembly's first term no one will wait more than 6 months for outpatient treatment?
	What has gone wrong?
	The Labour party could state that the Administration in Cardiff are not technically Labour; they are a Lib-Lab Administration. Technically, that would be correct. The Labour party could therefore try to blame the Liberal Democrats for the awful state of waiting lists in the NHS in Wales. Much as I dislike the Liberal Democrats, that would be dishonest. Although they will have to take their fair share of the blame, the Labour party would not have behaved differently if it had been able to muster sufficient votes to avoid having to rely on the Liberal Democrats to retain power.
	Let us consider the size of the problem: 4,335 people have been on the in-patient waiting list for more than 18 months1,810 more than when the pledge was made. In 1999, when the pledge on out-patients was made, 25,676 people were on the waiting list. Today, the figure is 83,443. When we left office in 1997, the figure was 5,956. What would Labour Members say if we had presided over that appalling state of affairs? It is a scandal.

Mark Tami: Does the hon. Gentleman agree that the 18 years of total under-investment in the health service led to the current waiting lists? We do not have sufficient doctors and consultants because it takes time to train them, and the Conservative Government were not prepared to do that.

Nigel Evans: I wonder how many more years the hon. Gentleman and his colleagues

Madam Deputy Speaker: Order. I remind hon. Members that we are not holding a general debate on the health service in Wales; we are discussing the Bill. It would be appropriate if hon. Members confined their remarks to that.

Nigel Evans: I am answering the Secretary of State's points. I listened to him carefully. The CHCs, which the Bill will retain, will also consider aspects of his speech.
	For how many more years must we listen to excuses? The hon. Member for Alyn and Deeside (Mark Tami) has to accept that the Labour party has been in power for more than five years. The statements that the Labour party made during the 1997 and 2001 general election campaigns

Madam Deputy Speaker: Order. Again, I remind the hon. Gentleman of the parameters of the debate. We are considering the Health (Wales) Bill.

Nigel Evans: Yes, Madam Deputy Speaker. As you know, the Bill deals with the retention of the community health councils, which will consider the aspects that we are discussing. We want to ensure their independence so that they can expose the issues that many hon. Members will doubtless raise today.

Huw Irranca-Davies: The hon. Gentleman mentioned five years. How long does it take to train a consultant?

Nigel Evans: Part of the problem is retention after training. I have spoken to the Royal College of Nursing, which states that there are 30,000 registered nurses, but that more than 8,000 do not stay in the NHS. The hon. Gentleman also knows that the Government have scoured the world for extra nurses and consultants, yet shortages remain. They must accept that there is a problem.

Bill Wiggin: My hon. Friend knows that consultants, especially in Wales, have not agreed a settlement with the Government. There is no point in Labour Members shouting abuse when the Government have failed to agree a deal with consultants on funding.

Nigel Evans: My hon. Friend is right. The statistics that we use in today's debate have a genuine impact on patients in Wales. People are suffering because of the deficiencies. That is the real problem.
	When I mentioned waiting lists to the Secretary of State earlier, he compared the NHS with an oil tanker and said that it had to be turned around. The right hon. Member for Holborn and St. Pancras (Mr. Dobson) once described the NHS as an oil tanker when he was Secretary of State for Health. Many Secretaries of State have passed under the bridge since then. The NHS now resembles the Spanish oil tanker that has sadly run aground and is currently spilling oil. Something must be done about the waiting list problem in Wales for the sake of all the patients in Wales.

Don Touhig: The hon. Gentleman must acknowledge the distance that we have had to travel in rebuilding the health service. Does he recall that under the Conservative Administration, 70 hospitals were closed, 8,000 general beds were removed from use and there was a 25 per cent. cut in nursing and midwifery training? We have had to travel that distance to start putting things right.

Madam Deputy Speaker: Order. Again, I remind hon. Members that we are discussing the Health (Wales) Bill, not the national health service in Wales.

Nigel Evans: In that case, I shall respond to the Under-Secretary only briefly. Many people will look back on 1997, when waiting lists were much shorter, and wish that the Conservatives were still in power.

Gareth Thomas: Will the hon. Gentleman give way?

Nigel Evans: No. I have given way often, and I want to move on.
	Community health councils will want to consider in detail the issues that we are discussing and expose some of the problems. I therefore believe that we should examine carefully CHCs' independence from the Assembly.
	I spoke about the professions that the Bill covers, including GPs. Let us consider some of the comments of Dr. John Chisolm, chairman of the BMA practitioner committee, who published a book entitled XCrisis in Care: A GP dossier. I heartily recommend it to all hon. Members who are present. They should examine the Welsh sections if nothing else. It is a harrowing read. He comments on some of the GPs who work in Wales and will be covered by the CHCs. One is Andrew Dearden, a doctor from Cardiff. He says that some people wait as long as six years for hip replacement operations.
	He states:
	XI have many patients who are crippled by arthritis and need hip replacements. The word 'crippled' is not an exaggeration for many of themsome are completely housebound and do not go out of the house except to attend hospital appointments. They are often on multiple painkillers, none of which are controlling most of the pain.
	While we debate the Bill today, let us keep in mind the people to whom it relates: the patients facing lengthy waiting lists with GPs. The GPs are hugely frustrated by that.

Gareth Thomas: Can the hon. Gentleman tell us whether his party supports the Bill? Does he agree that rather than embarking on a regurgitated rant, he would do the House a greater service if he told us whether he supports the technicalities of the Billyes or noand why?

Nigel Evans: The hon. Gentleman will have to be a little more patient. We support some aspects of the Bill, and we will wish to improve some aspects of it when it reaches Committee. I hope that the hon. Gentleman will serve on that Committee. No doubt we will then be able to debate at length improvements to the Bill. The hon. Gentleman may be surprised to find that amendments are tabled even by his hon. Friends.
	The Secretary of State said that the Opposition did not want a national health service, and that under the Conservatives only the rich would get treatment and those who were poor would not. It is a chilling fact that 250,000 people last year used their own money to have operations. That is the figure for the whole of the United Kingdom, and some of those cases would have been in Wales. People withdrew their life savings or borrowed money because they were in pain and the waiting lists were far too long.
	We must focus carefully on what the Bill is about. We all want an improvement to the service provided to the people of Wales. That is why we want to ensure that the Bill is improved in Committee.

John Bercow: Is my hon. Friend aware that a cursory study of the Bill suggests that it contains no fewer than 18 references to orders and regulations, rendering it something of a parliamentary eunuch? Does he agree that it is therefore essential that we are told tonight by the Government whether the regulations will be subject to the negative or to the affirmative procedure, and that the National Assembly for Wales publishes draft intentions of what it plans to introduce?

Nigel Evans: I agree with my hon. Friend. That would be an informed position for the Assembly to take. As we see from the Bill, many powers are to be devolved to the Assembly. I want to know what consultation the Assembly will have with various bodies before it introduces regulations that will impact on the whole of Wales.
	I read the second report of the so-called First Minister, Rhodri Morgan, for 200102. I wanted to see what he had to say about the NHS, because it is devolved through secondary legislation. Only three of the 35 pages are devoted to the NHS. The First Minister sets out some of the targets. One of those strangely and boldly states:
	XIn the main, the maximum waiting times for orthopaedics have been reduced to 18 months.
	I do not know what is meant by Xin the main. I do not see that as a target, but there we go. I then looked at the statistics made available by the NHS in relation to orthopaedics. It is clear that in most of the health authority areas, the waiting time for orthopaedics is more than 18 monthsthat is, more than 72 weeks.

Mark Tami: Does the hon. Gentleman agree that all his arguments show the need for investment in the health serviceinvestment that his party opposes?

Nigel Evans: I agree that investment is needed in the health service, but it must be investment in the right areas. Clearly, the investment is not going into the right areas at present. I hope that with his interest in the health service in Wales, the hon. Gentleman would want to ensure that the extra national insurancethe extra taxationthat everyone is paying goes into the right areas. When people are taxed to the hilt and receive the sort of service that we are discussing, they feel aggrieved.

Lembit �pik: Which areas of the health service would the hon. Gentleman not invest in? Out of which areas would he take money?

Nigel Evans: The hon. Gentleman, as a Liberal Democrat, is part of the coalition, or the official irritation, as I prefer to call it. His party is just a poodle for the Labour party in the Assembly, and Labour's little helpers at Westminster. When there are more managers than nurses in the NHS, we must refocus on where the money should go.

Huw Irranca-Davies: Will the hon. Gentleman give way?

Nigel Evans: No. I must make progress.
	Will the Secretary of State please look again at the waiting lists for orthopaedics and see how many people have been waiting for way over 18 months? That is a real problem, which must receive the proper attention. It is pointless having targets if they are not likely to be met. Why does the Assembly promise what it cannot deliver, and why does it claim credit for what it cannot achieve?
	Why did Rhodri's second report, if it was to be honest and transparent, not give us all the figures for waiting times so that everyone could judge what the Administration had promised and what they had achieved? The document is spin. Unless the Administration are fully truthful about the position next year, I suggest that they do not bother to produce a report next year, and instead put the money saved towards employing an extra nurse. I suggest an extra nurse because, despite all that the Secretary of State said earlier, there are still 700 vacancies in the NHS for nurses, even though there are 1,000 Filipino nurses working in the health service in Wales. Thank goodness for the job they are doing, but there are still almost 750 vacancies.

Roger Williams: Has the hon. Gentleman's party estimated how much money would be saved by cutting the administration of the NHS in Wales?

Nigel Evans: The hon. Gentleman should know that we would at least examine the areas in which the bureaucracy has grown, where the number of managers has grown and where there are inefficiencies, instead of making excuses all the time to explain why more money has to be pumped in while services are deteriorating. The sad thing for him and his constituents is that they are getting a worse service at the same time as they are paying extra taxes.

Huw Irranca-Davies: rose

Nigel Evans: No. I must make a little more progress. I know that other hon. Members want to take part in the debate.
	Part of the Bill deals with Health Professions Wales and the directions that the Assembly may give to health workers, including nurses. Part of its function must be to ascertain that newly qualified nurses earning 15,000 feel properly valued in their roles. How can we retain them when they are qualified, and how can we encourage more of the newly qualified nurses to go into nursing? Pay is vital, and we all await the outcome of the Agenda for Change at the end of the year, and the impact of Health Professions Wales in ensuring training for our nurses, and ensuring that the training will come to something. It must be a matter of deep concern that so many of those who are trained do not go into nursing at the end of their training.
	All of us who read the Western Mail today saw with great delight that 14,000 has just been spent on a new logo for the Welsh Assembly14,000 on a new dragon. What a waste of money. The patients waiting for operations could not care a jot about such expensive trivia. If a new logo costs 14,000, and a nurse costs 15,000 a year, on what would hon. Members prefer the money to be spent?
	We all want an improved national health service in Wales. Will the Bill deliver that? It contains no reference to foundation hospitals, which were mentioned by Plaid Cymru Members earlier. The Government believe that foundation hospitals are the answer for England, but not a mention of them for Wales. I wonder why. The retention of community health councils is to be welcomed, as are their enhanced powers, but the power given to the Assembly to decide whether they could be abolished in the futureindeed, the very name could be changed by the whim of the Assemblyis over the top and unacceptable.
	Yes, it is right to ensure that the whole of Wales is covered by CHCs, but we need to examine ways of giving the CHCs greater autonomy, away from the Welsh Assembly. They could fall foul of the Assembly by exposing many of the deficiencies in the health service in Wales, some of which I have highlighted. The CHCs could then face the bullet; they could be abolished, just as has happened in England. Many hon. Members here today helped to bring that about by not supporting the retention of English CHCs. Only one Member from a Welsh constituency voted against their abolition.
	Part of the CHCs' remit is to be the patients' champion. When the newly reformed national health service in Wales gets off the ground in April of next year, we know that it is going to be hugely bureaucratic. We also know that it is going to be expensive. Even a former Welsh Office Minister has termed it Xunworkable. A leaked report presented to Rhodri Morgan, Jane Hutt and the Secretary of State for Wales by the senior civil servant, Bryan Mitchellthe man overseeing the reformstated that there were major risks involved in the reorganisation. We were told that it was going to be cost-neutral; we now know that it is going to cost 15 million. The Secretary of State for Wales assured me in the Welsh Grand Committee that this was a one-off payment. We will compare the costs after the 22 local health boards are up and running, to see whether the change has been cost-neutral. People should have this kind of information before they vote these measures through. There are also a number of other concerns relating to the reforms. Let us suppose that the CHCs blow the whistle on all this, when the new organisations are up and running. What protection will there be for them?
	We know that Jane Hutt receives a lot of criticismall of it fair, in my book, yet she hates it. She has stated that
	Xpeople don't want to hear the media bashing politicians. They want to know about us driving waiting lists down.
	Well, there is not much chance of that, is there? What she fails to recognise is that the reason she is being bashed is that she is signally failing to do as she promised. No doubt the Assembly would like to have the same powers over the media as they are being given over the CHCs. In the Bill, it can decide the membership of the councils, the means by which the chairman is elected, the proceedings of the councils, and the discharge of any function of the councils by a committee of the councils. The Assembly will also be able to decide who consults the councils, the payment of councils, the preparation and publication of reports by councils, matters to be included in any report, what the councils may receive from health authorities, local health boards, strategic health authorities, primary care trusts or NHS trusts, what sort of information they can give out to other people or other councils, and anything else that takes its fancy.
	Gosh! If only the Assembly had such powers over the media! It could appoint editors and journalists, decide what goes into the newspapers, what information the public could and could not read, and who that information went to. What sort of far-reaching, searching publication would that produce? Well, it would be a bit like Rhodri Morgan's report to the Welsh Assembly and the people of Wales: wholly spun, wholly disinfected, wholly engineered and wholly useless. Anyone who believes that the Assembly would not use its powers unreasonably should remember that it abused its powers by delaying the local elections from 2003 to 2004 so that they did not coincide with the Assembly elections. That was a complete disgrace, but it is going to happen.
	We need much more protection and independence for the CHCs. If we want them to be a whistleblower and a champion for the people of Wales, let us give them some independence from the body that might well be on the receiving end of some of their criticism. I want the CHCs to be empowered to check on all the organisations giving health services to patients in Wales, but I want them also to liaise with other bodies in England, Scotland and Northern Ireland, so that complaints may be taken up from any patients receiving care in facilities in Wales. I would like similar rights to be afforded to Welsh patients receiving care in institutions in other parts of the United Kingdom.
	I also wish the CHCs to be consulted and involved in any name changes, abolitions or mergers. More autonomy and independence for CHCs will be important. It is also important that CHCs should consult the people of Wales and issue an annual report on the people's views on the service that they are receiving. Those views will be positive in many regards relating to the people working in the NHS, but I receive letters on a regular basis about the state of health provision in my own area, and it is not always so positive. Only if we encourage this sort of publication will we all learn about any deficiencies, and I am sure that best practice would lead to fundamental changes being made throughout the whole of the NHS.
	The Wales Centre for Health has been widely welcomed, and we will be looking for ways in which it can engage in a constructive dialogue with comparable bodies elsewhere in the UK. One of its remits is to keep people in Wales informed on matters that affect their health. That is right, but much of the information gathering and research could well be carried out elsewhere. Furthermore, it could be pioneering an area of health concern and be way ahead of what someone else is doingon certain aspects of drug abuse, for exampleand, in such circumstances, it would only be right for the information involved to be shared and for collaboration to take place, to give any information campaigns the greatest effect.
	I see that the Assembly is to give itself the power to appoint the chairman of the Wales Centre for Health. I hope that that will be done in an open and transparent way, and we will look for ways of ensuring that that is the case. Evaluation of the centre's work will also be important, in terms of assessing how effective it is in getting positive health messages across. We will examine how that can best be achieved. I see that the Auditor General for Wales has responsibility for this provision in the Bill. There will be budgetary implications for this body.
	Today's report that parents in Neath, Port Talbot and Swansea are shunning the measles, mumps and rubella jab in increasing numbers must be of concern to the Government. More than 25 per cent. of children have no immunisation at all, and the fear is that this could lead to an outbreak of measles, mumps and rubella. The Wales Centre for Health may well be involved in research into the fears of a growing number of parents about autism. Indeed, it may wish to make recommendations on single jabs being made available.
	Health Professions Wales will work closely in liaison with a number of other bodies. We will wish to see that it works closely in consultation with the bodies and professions that it covers, especially nurses. I have a concern about the training and qualifications necessary to work in the Welsh health service, and I would like to see training and regulations there that are very similar to those that exist in the rest of the UK. Wales is a small country, and nurses might find themselves unavailable for work in Wales if they had been trained in England or, for example, if they were agency nurses who could not get work in Wales if they lived in Bristol, because a wholly different system was operating in Wales. Given the nursing shortage to which I referred earlier, I would have thought that flexibility and ease of working in Wales would be the byword, as opposed to seeing how different from England or Scotland we can make the system.
	I wish to see a world-class health service in Wales, with our dedicated staff receiving the best support and our patients receiving the best care. I am angry that this is not happening after more than five years of a Labour Government and three years of a Welsh Assembly. The number of promises was high. The criticism of the NHS under the previous Conservative Government was constant, but I do not remember Labour Members ever rebuking themselves in those days for talking down the NHS by making constant criticisms or by pointing out where things were going wrong.
	The Government are embarking on further change, on top of other changes, and this constant change cannot be good for the system. After all the changes that have been madeand with the differences from other parts of the countryit will not be a case of not knowing where the buck stops for most people; it will be impossible to work out where it starts. We have massive fears about the changes contained in the recent health reform legislation, as it affects Wales. I believe that they are going to cost a fortune and will be unworkable. Mergers will be almost inevitable as local health boards find that they have to join up with others to make a go of the new provisions. The changes mentioned in the Health (Wales) Bill could lead to progress, so long as we can ensure that these bodies have some independence from the Assembly and are given teeth.
	We want to see a better health service. The people of Wales were promised that, and they do not deserve what they currently have. Jane Hutt, the Health Minister in the Welsh Assembly, is drinking at the last chance saloon, andeven with the prospect of licensing reform and the possibility of 24-hour drinkingthe bell for last orders should be ringing long and loud in her ears.

Martyn Jones: I would be grateful if I could take some time to discuss the background of the Bill, before considering the principle that we are discussing on Second Reading. I would like to do so because it was the Welsh Affairs Committee, of which I am proud to be Chair, that was charged with the responsibility of providing the main pre-legislative scrutiny on behalf of the House. Likewise, the mirrored responsibility from the perspective of the devolved National Assembly for Wales fell to the Health and Social Services Committee of the Assembly in Cardiff.
	There was, of course, an input to the draft Bill process from the Welsh Grand Committee, under the excellent stewardship of my hon. Friend the Member for Bridgend (Mr. Griffiths), and that provided a useful Third Reading-style stage of the pre-legislative process, throughout which, I believe, only one voice expressed concern that the scrutiny by the Welsh Affairs Committee was somehow a bad precedent to set. The reason given was that not all members of the Committee represent Welsh constituencies. That is a fact, but it is hardly the fault of the House that the Welsh people do not elect a single Welsh Conservative Member. In any case, that is no excuse for precluding the Welsh Affairs Committee from repeating its scrutiny role and the process would be fundamentally flawed if the official Opposition were effectively excluded.

Jon Owen Jones: Although I was not named, I must speak in my defence. I believe that we have set a bad precedent, because in the event of another Governmentpossibly a Tory Governmentbeing elected, the Select Committee could have a majority of members from outside Wales. We have set a poor precedent, because it will be used against us when we have another Government. I do not believe that the Labour party will be in power constantly.

Martyn Jones: I am shocked by that suggestion, but I must point out to my hon. Friend that, in any case, the Standing Orders of the House say that every Committee of the House will have a Government majority. Whatever Committee considered such a matter, it would, dare I say it, have a Tory majority were the Tories to be elected.

Jon Owen Jones: I am thankful to be allowed a second go. To correct my hon. Friend, Standing Order No. 86, which we must set aside at the end of the debate, allows Bills exclusively about Wales to be debated by a Committee whose members are all Welsh Members. That is in the existing Standing Orders.

Martyn Jones: A Government who are not a Labour Government could change that Standing Order overnight, as my hon. Friend is well aware. Yes, that Standing Order exists, but if a new Select Committee were set up to discuss Welsh business it would have a majority from another party should such circumstances arise. I am sorry, but that has to be the case, as no Government will ever set up a Committee with a majority of Opposition Members.
	By the way, my hon. Friend may not be aware that another Member made such a suggestion in the debate, so the cap that he takes up may not fit him. He may recall that a Member on the other side of the House said something along similar lines about the Welsh Grand Committee. That said, if the cap fits Members on either side of the House, whoever wants to can wear it. I sincerely believe that the Select Committee represents the best process under the rules of the House.
	My hon. Friend may or may not agree with what I shall say next: a better change may be to alter the Standing Orders to allow joint working with Assembly Committees.

Roger Williams: I compliment the hon. Gentleman on his work with the Welsh Affairs Committee. Does he agree that one benefit arising from the process is the enhanced legislative understanding and trust that developed between the Assembly and Westminster?

Martyn Jones: Absolutely. I am sure that the hon. Gentleman, who is a valuable member of my Committee, endorses the process, which I have adopted since becoming Chairman of the Committee and since the Assembly was established, of keeping Assembly Members on board at all stages and at no stage, I hope, treading on their legislative toes. That is a self-denying ordinance, but one on which there is general consensus in our Committee.
	The Select Committee greatly welcomed the opportunity to take the lead on the draft Bill, which, from a public consultation perspective, was a huge success. In total, 307 organisations and individuals were consulted and, as the Wales Office website rightly boasts:
	XThis is the first piece of Wales-specific legislation to be subject to public consultation in draft form and pre-legislative scrutiny by Parliament and the National Assembly.
	I can assure the House that the process was extremely successful, and I am therefore delighted that the Queen's Speech contains the pledge that the Government intend to publish even more draft Bills to give Parliament and the wider public a greater opportunity to scrutinise proposals before the more formal legislative process takes place in the House.
	I thank the previous Secretary of State and the Under-Secretary for their work and, indeed, the spirit with which they entered into the draft Bill process. I also place on record my sincere appreciation of Jane Hutt, the Minister for Health and Social Services in the Welsh Assembly Government in Cardiff, who provided leadership in making the draft Bill process the success for Wales that it has proved to be. However, I add one general suggestion, which I hope is helpful, on the legislative process in relation to the Bill and, indeed, future draft Bills: why does not the House consider holding truncated debates on Second Reading? Members will probably fill the time allotted tonight, in good old Parkinson tradition. However, given that we have had one crack of the whip, perhaps we should cut down debates on Second and Third Reading.
	The Government have accepted most of the technical amendments proposed by the Select Committee and the Welsh Assembly during deliberations on the draft Bill, so we should be discussing only parts of the Bill on which amendments were not accepted. In the light of the Government's promise in the Queen's Speech to present further Bills in draft before the formal legislative process begins, I urge them to re-examine the necessity for full Second Reading debates so as to save valuable time in the House. Briefer consideration in Committee will come naturally, but perhaps debates on Third Reading could also be shorter.
	When the draft Bill was published in May, it was a good day not just for health in Wales, but for Wales's democracy and parliamentary accountability. I am proud of the Government's commitment in creating that groundbreaking precedent. The real benefits of presenting the Bill in draft have come to fruition, as it offers legislation for Wales that was consulted on and debated in Wales before the House began its deliberations on the details. This is truly Xhome-grown legislation. Importantly, the Bill is also testimony to the fact that devolution in Wales and the relationship between this place and the National Assembly in Cardiff have come of age. The Bill proves, conclusively in my mind, that London and Cardiff can and will work together for the benefit of the people of Wales.
	The Bill will deliver huge benefits for patients in Wales by giving them a much stronger voice, not only in improving the NHS in Wales, but in running the health service. Patients will be empowered, and I am proud that it took this reforming and imaginative Government to find the way to enable patient power to come into being. They are to be congratulated on that.
	The Bill is an important step in the revitalisation of the NHS and it cannot be viewed in isolation from the massive increase in investment that has been injected into the NHS in Wales over recent years. I believe that, today, an extra 1 million has been allocated for the ambulance service in Wales. I hope that the Under-Secretary mentions that in his winding-up speech, as it needs to be put to the public.
	When the Government talk of reform, they mean reform, and the Bill is an intrinsic part of that strategy in Wales. It is designed to ensure that the patient's voice is central in the creation of improved services right across the board, and in accepting pre-legislative responsibility the Committee recognised and, I hope, built on that important factor.
	Underpinning that empowerment of the patient is the progressive transformation of community health councils across Wales. That crucial strand of reform is to be enhanced by their taking on the new role of being responsible for nursing homes and primary care. CHCs across Wales perform excellent and dedicated work, not just in terms of their quasi-inspectorate role, but through advocacy. The Welsh Affairs Committee wanted CHC members to have a statutory right to take time off work to attend CHC meetings and formal visits. I would like the Government to return to the matter and amend the Employment Rights Act 1996 to include CHCs in the list of approved public bodies.
	Another recommendation that the Government did not accept in their response relates to a review in respect of Welsh CHCs not being constrained by the borders of Wales when acting on behalf of Welsh patients who are receiving treatment outside Wales. Wales is in a unique position, particularly the more rural parts of mid and north Wales, where many patients have to travel to Shrewsbury, Oswestry, Telford and even Manchester for treatment. I would have liked to see this uniqueness addressed. Again, I would ask the Government to reconsider this matter in Committee.
	The Bill also advances the setting up of a brand new and encompassing health professions body for Wales, which would in future include health specialities such as physiotherapy and speech therapy. Health Professions WalesHPWwill also replace the functions previously carried out by the Welsh National Board for Nursing Midwifery and Health Visiting, which is to be abolished in the near future.
	In evidence sessions, the Select Committee quickly formed the view that the proposal to set up Health Professions Wales has been broadly welcomed. However, the Committee expressed concern about the independence of HPW in relation to staff and funding issues. We are pleased that the Government clarified the extent of the powers in their response to the Committee and in the Bill.
	The Bill offers to Wales a bold change of emphasis from just treating disease to looking at the Xbig picture of setting out to improve the general health of people in Wales. I believe that that will be greatly helped by the establishment of the Wales Centre for Health, which will offer support training and share advances in cutting-edge medical research throughout Wales. On the independence of the WCH, I am pleased that the Government accepted the Select Committee's recommendation that the Assembly's powers of direction over the WCH should be limited to
	Xthe exercise of its administrative or financial functions
	and that the Bill is specific on that matter.
	In the evidence sessions, the Select Committee highlighted, but did not submit as a specific recommendation, the evidence of some witnesses who wanted the WHC's remit widened to enable it to be more proactive in offering advice and information to the public. Again, we are pleased that the Government recognised the matter and elaborated in the Bill on the WCH's role in relation to that function. The Government also responded positively to the National Audit Office query about the role of the Auditor General for Wales to carry out value-for-money investigations into the WHC's work. That is now included within the Bill.
	The Bill, which was brought to the House via the route of pre-legislative scrutiny, has been a resounding success. Not only has that process marked a progressive and organic approach to drafting legislation but, more importantly, as the Bill demonstrates, it has delivered good legislation. In this case, that is good news not just for the NHS in Wales, but for the standing and reputation of this House.

Lembit �pik: The Secretary of State correctly said that many hon. Members would welcome this Second Reading debate. It is always pleasing to see people from all over the world celebrating our deliberations on what I like to think is, by and large, a Bill arrived at by consensus. As the hon. Member for Clwyd, South (Mr. Jones) said, it is a credit to the pre-legislative scrutiny that so many people have been involvedMembers of this House, Members of the Assembly and health professionals. In the past, we have not always realised the importance of working closely with the Assembly. Let us hope that this useful precedent will lead us towards more effective representation of the people of Wales in the future.
	The Secretary of State also said that the Bill is about patient power. Actually, I think that it is about patient health. We must make sure that we do not become obsessed with process. All four parties present want to ensure that we maximise the effectiveness and value for money that the public get from the system. In that sense, the consultation process has, one hopes, been all to the good, because it has made stakeholders out of individuals who are on the front line trying to deliver the service.
	I was, as ever, entertained by, and delighted to listen to, the hon. Member for Ribble Valley (Mr. Evans). Most Welsh Liberal Democrats were grateful that he did not put all the blame on us for the problems of the health service. He is a very nice manmost Liberal Democrats think that, with the possible exception of Michael Carr. The hon. Gentleman got some considerable heat for the 18 years of underfunding which many believe were instrumental in causing the problems in the run-up to 1997. I noticed the relief on his face when Madam Deputy Speaker intervened to protect him, giving him a lucky escape, lest people were reminded of the 70 closed hospitals and the 8,000 lost beds. I agree that the hon. Gentleman's swingeing attack on the Government had about as much relevance to this debate as improving standards in the Estonian health service. In fact, those improvements are impressive and I would recommend that hon. Members go to Estonia to see how it is dealing with its outstanding health problems.

Bill Wiggin: Is the hon. Gentleman proud of the current state of the NHS in Wales?

Lembit �pik: I can honestly say that I am. I think that the health service does a damn good job. I shall return to that matter in a moment. We must all celebrate the fact that the United Kingdom is extremely fortunate that, despite all the issues, we still enjoy some of the highest health standards enjoyed by any society at any time in the history of the planet.

Huw Irranca-Davies: I would join the hon. Gentleman in celebrating the standards in the national health service. When my mother was taken into Morriston hospital in an emergency last weekend, the quality of care that she received was first class. She spent two days there and now, thank goodness, she is back home. That was not the first time that she had been taken into hospital; it was the third occasion. Each time, she has been dealt with admirably, so let us not slate health service in the way that it is so often slated.

Mr. Deputy Speaker: Order. Before the hon. Member for Montgomeryshire (Lembit pik) responds to that, may I say that this is not a general debate about the health service in England or Wales, and I should be grateful if hon. Members would confine their remarks specifically to the Bill before the House.

Lembit �pik: I certainly will, Mr. Deputy Speaker, and I apologise for bringing Estonia into the debate as well.
	As I listened to the hon. Member for Ribble Valley discussing the Bill, I became increasingly nervous because I simply did not know whether the Conservatives were supporting the Bill tonight. At one point, I almost intervened on a point of order to ask whether it was in order for the hon. Gentleman to expose us to such stress. In waiting for the answer, we may have developed some stress-related disorders.
	The hon. Gentleman explained on behalf of the Conservatives where the money should come from to improve the health service. In answer to my question to him, we received only one figure: he would save 14,000 by abandoning the logo project. That would pay for almost a year's worth of nursing[Interruption.]

Nigel Evans: Will the hon. Gentleman give way?

Lembit �pik: I believe that my point is almost in order, Mr. Deputy Speaker, so on that basis I shall give way.

Nigel Evans: I said that 14,000 was being wasted on the logo. I could have gone on to give a whole list of ways in which the Welsh Assembly is mis-spending the money, including the new Assembly building, but I did not mention that in case Madam Deputy Speaker ruled me out of order.

Mr. Deputy Speaker: Order. I fear that hon. Members are starting to stray again and I must insist that they do not.

Lembit �pik: The point just made by the hon. Member for Ribble Valley brings me right back to the research paper published on 20 November to explain various aspects of the Bill. It says on page 16:
	XThe draft Regulatory Impact Assessment, published by the Wales Office to accompany the draft NHS (Wales) Bill, estimated that CHCs' enhanced visiting rights would cost around 100 million a year across Wales, while the enhanced advocacy role would cost 480 million per year. The cost of putting the AWCHC on a statutory footing and increasing its responsibility and powers was estimated at 10 million per year in additional rates and rents and 70 million a year in additional staffing.
	The estimate for the cost of all the measures in the Bill therefore comes to a substantial 660 million a year.
	We did some investigation in the House, however, and it transpired that it comes to 660,000 a year, so in one fell swoop the Welsh Liberal Democrats have saved Wales 659,340,000 already, while the Conservatives could come up with only 14,000.

Wayne David: Does the hon. Gentleman therefore welcome the fact that the National Assembly Government have already publicly announced an extra allocation of 550,000 for the enhanced role of CHCs in Wales?

Lembit �pik: Indeed, that shows that we are quite close to the estimate within the research document.
	The Bill has attracted an encouraging degree of consensus in the Chamber, because much of it has been fashioned on a cross-party basis. Crucially, it has been fashioned with outcomes in mind. The proof of the pudding will be in how it is implemented but in my judgment this is an evolutionary step. Those who were in favour of devolution wanted the Assembly to have greater autonomy in defining how the many different elements of health were provided in Wales.
	One of the Bill's crucial elements is the Wales Centre for Health. If it is handled correctly, it could provide a powerful strategic drive to the work and thinking of the Assembly in defining what the Secretary of State said he wanted: a health service specifically tailored to Wales. He mentioned plans for thousands of extra nurses and hundreds of other staff in the health service in Wales, which is to be welcomed. It is a credit to the Welsh Liberal Democrat-led coalition with Labour in the Cardiff Assembly that so much has been achieved.

Jon Owen Jones: Will the hon. Gentleman give way?

Lembit �pik: I knew I would not get away with that.

Jon Owen Jones: If the Liberal Democrats claim so much credit for leading the Welsh Assembly on so much, why is it that the Welsh Assembly intends to renege on a commitment to rebuild Cardiff royal infirmary in my constituency and that of the former deputy leader of the Welsh Assembly, Jenny Randerson? Although Ms Randerson, the Member for Cardiff, Central in the Assembly, has condemned that decision, she apparently is powerless to do anything about it. The Liberal Democrats cannot have it both ways.

Lembit �pik: I shall save you the bother, Mr. Deputy Speaker, of ruling me out of order for attempting to reply to that intervention. I will be happy to discuss that matter with the hon. Gentleman later. I assure him that, as the Secretary of State saidI think that it was a sincerely held point, made in the spirit of the debatethere are still lots of problems in the health service in Wales.
	To be a little more serious about the coalition, what is interesting is that the Welsh Liberal Democrat-Labour coalition is working hard to achieve the consensus out of which this Bill has been born. What is even more interesting is that there has been constructive input on the Bill from four parties. As I have saidI will not dwell on it particularlythe kind of new politics that we promised a few years ago when we were campaigning for a Welsh Assembly has probably led to a Bill of this sort coming before us now. I am greatly encouraged by that.
	There is one risk associated with the Wales Centre for Health. If, in working and offering guidance to the Welsh Assembly, it becomes the strategic driving force that I believe it can be, it is likely that there will be increasing divergence between what happens in Westminster for the English health service and what happens in Wales. That would be a healthy development for Wales but I imagine that it could cause strains between what we discuss here for England and what is discussed in the Assembly for Wales. I hope that the potential resistance of the Government in Westminster, who could be uncomfortable about the guidance given by the centre, will not come about.
	For that part of the Bill to work, there must be some tolerance in terms of the divergence, which could put a strain on other health-related debates here. There must be an acceptance that we are trying to find, to use the sort of language that the Secretary of State used before he left the Chamber, Welsh solutions to Welsh health issues.
	If the Wales Centre for Health does its job well enough, current best practice could be imported from Wales to England. Again, it requires a new kind of politics, enabling Ministers to take the opportunity, without loss of face, to look at the devolved institutions and to say that the Westminster Government can learn something useful from what has happened elsewhere.
	The issue of foundation hospitals and whether they should have been included in the Bill is a good example of divergence. I am not convinced by some of the statements by the Government for England with regard to health provision. I agree with what the hon. Member for Ribble Valley said about divergence.
	The Government's language on the health service now seems to include creeping terminology about failing institutions. That sort of psychology has done a lot of damage in the education sector. The Bill may help to protect us from the same danger creeping into Wales.
	Certain specific points relate to cardiac and orthopaedic services. While I am very happy with the service that I and my mother, who has had various health problems, have received, again, the strategic approach that the Wales Centre for Health and the community health councils could provide across Wales could deal with the issues that we are all concerned about. Waiting lists concern meI think that they concern us allbut by working together we can perhaps get those down.
	I was heartened by the fact that the Conservatives have travelled around various parts of Europe to see best practice. It is ironic that they are so pro Europe in that respect but not quite so keen on other aspects of harmonisation.
	On the question whether the Bill can save money, we need to be honest. It is very difficult to save money in the health service because, ultimately, when people feel better, they live longer. The quality of life improves but the health bill does not reduce. The NHS was originally set up in the belief that it would save money for the Government by reducing illness. It has improved life expectancy and the quality of life of individuals but that has come with a large price tag, not least because technology costs a lot more. Often, technology costs increase at a higher rate than the underlying inflation rate in the health service. This is not the place to discuss that but we should not pretend to anyone that by supporting and passing the Bill anyone will save a significant amount of money in the health service.
	The hon. Member for Cardiff, Central (Mr. Jones) said, with insight, that he did not believe Labour would always be in power. How right he is. He knows that the Liberal Democrat Government are just round the corner and already operating effectively in Wales.

Peter Luff: Round the bend.

Lembit �pik: That was quite good.
	Since we intend to govern responsibly, we need to pave the way now so that we do not have to pick up problems.
	On other key points, we need to understand exactly the role of the community health councils. That is fairly clearly laid out in the document but there is a side issue about boundaries and co-terminosity. Kirsty Williams, the Welsh Liberal Democrat Assembly Member, who has done a lot of work to help to construct a modern health service in Wales, has pointed out that, although we should respect natural boundaries for local authorities, there may be occasions when having more than one community health council will be effective in the Wales environment. Being parochial for a moment, Powys, for example, has two community health councils; one would be unmanageably big and it probably would not be reasonable to expect one individual community health council to do the work.
	Many of the figures cited have come from independent advocacy services. A rough figure of 500,000 has been mentioned, but we must be careful to recognise that the costs are estimates and while those estimates sound okay, it would be a great shame if the intention of the Bill were thwarted by the fact that the community health councils did not have the necessary resources. Even 1 million is not a huge proportion of the Welsh health budget. We back the principles in the Bill, based on an acceptance of flexibility. We should work reasonably with the Assembly, ensuring that it does not end up in an impossible position by trying to fund something from its existing budget that is unfundable, given that it is primarily a Welsh Assembly responsibility.
	It may sound like a detail but it was suggested by the Select Committee on Welsh Affairs that prisons be transferred into the ambit of the Bill. Hon. Members will correct me if I am wrong, but I do not believe that that has been done. I think that it is unfinished business. It would be strategically more sensible to do that now, rather than to return to it in future.
	The next steps are fairly clear. We will need a constructive Committee stage but, as has been noted, it is likely that our proceedings will be relatively uncontroversial, as many big issues have been resolved. However, various amendments will have to be tabled.
	The Welsh Liberal Democrats in particular will want to deal with matters that might fall outside the Bill. We have talked about free, long-term personal care for many reasons. Lloyd George said that the measure of a civilised society is how it treats its elderly. My hon. Friend the Member for Sutton and Cheam (Mr. Burstow) has worked in that sector, and has suggested that tomorrow's debate on community care might be a better opportunity to discuss legislation to achieve that goal. However, I raise the point now as these matters are interrelated.
	Much research suggests that the introduction of free dental and eye tests

Mr. Deputy Speaker: Order. Perhaps the hon. Gentleman can return to the Bill.

Lembit �pik: I apologise, Mr. Deputy Speaker, if I was deviating. I recognise that, to include provision such as free dental and eye tests, the long title of the Bill would have to be changed. That is unlikely to happen in Standing Committee, but it is ironic that the matters to which I have referred could come back to the Floor of the House for discussion, given the advice that I imagine that the Wales Centre for Health will come up with once it is established.
	The constructive debate tonight has been encouraging, and I think that the Standing Committee deliberations will be constructive too. I hope to hear the useful and ever friendly criticisms from Tory Members.

Nigel Evans: Earlier, the hon. Gentleman mentioned orthopaedics, for which waiting lists are way above the 72-week target. Does the hon. Gentleman consider that a useful role for CHCs could be the production of annual reports detailing the views of patients in each area? That would highlight where the real problems are, and thus enable a focus on solutions to reduce waiting lists.

Lembit �pik: That sounds like the sensible sort of role envisaged in the Bill. I am concerned about tying CHCs into too much repeating bureaucracy, as I believe that they will operate best on an ongoing and proactive basis. They should identify and deal with local issues, without having to go through an eternal cycle of preparing reports. However, that is an important matter for consideration in Committee.
	Another such matter is whether CHCs should be authorised to go into private health providers, even when there are no NHS patients in them. There is no point in rehearsing the various principles at stake, but I hope that we can discuss the possibility. More encouraging is the way in which the CHCs will have pretty wide powers to investigate the general quality of provision. If we work on the basis of success rather than failure, the CHCs could be critical friends for the institutions that they inspect.
	I hope that a reasoned debate in Committee will help build relations between Westminster and Cardiff. After a slow start, that relationship is fast improving. It could also help create a healthier health service. If that leads to a healthier Wales, it would be a credit to the Bill and all those involved in it.

Huw Irranca-Davies: I am pleased to contribute to this debate, as I was when the Bill was discussed in the Welsh Grand Committee in the summer. I have read the extensive work done by the Select Committee on Welsh Affairs on the Bill, and I pay tribute to that.
	The Bill is a modest but important step towards increasing joint scrutiny of draft legislation by the National Assembly for Wales and this House. Such parallel scrutiny sets a good precedent, and I am glad that the Government are committed to ensuring that more Bills are handled in that way.
	The diversity to which devolution has led is relevant to the Bill. For those who, like me, are powerful supporters of devolution, it is a recognition that different solutions may apply in England and Wales, and that there may be learning experiences to be derived from both. That is to be celebrated, not scorned. We are aiming to secure good health care provision for all communities on either side of the border. If a different approach is adopted in Wales, so be it: results are what matter.
	The Bill will establish the Wales Centre for Health, which will gather and disseminate information on health provision in Wales. That is a vital and long overdue function. The Assembly has made great strides in that direction already, especially in recognising the problems of prevention as well as repair when it comes to health. A great tragedy of many Welsh communitiesespecially where there are high indices of multiple deprivationis that chronic and long-term health problems are exacerbated by poor housing, low aspirations and so on. That is something to which the Wales Centre for Health can turn its attention and for which it can work proactively to find solutions.
	I also welcome the proposed centre's ability to undertake and commission research. It is right that, under the devolution settlement, that research should be passed down to the Wales Centre for Health. The centre will look at where research is needed, seek solutions and put forward proposals, instead of everything being steered by Westminster. That shows a level of trust in the Assembly and the process of joint scrutiny. The centre will also provide Welsh solutions in matters such as the development and provision of training in the health sector, and that is to be greatly welcomed.
	The Welsh Centre for Health will face great challenges. In many of our communities, health problems are huge, long-term and entrenched. In Bro Morgannwyg, for example, heart disease affects more than 20 per cent. of the community. The figures for respiratory diseases, asthma and arthritis are 25 per cent., 12 per cent. and 26 per cent., respectively. Mental illness, the constant Cinderella of health care, affects 13.7 per cent. of the people in my area.
	The Welsh focus that a Welsh Centre for Health will provide can really tackle such problems, by developing research and making good proposals that tackle local needs.

Nigel Evans: The hon. Gentleman has mentioned a number of problems, but was he alarmed to read today that people with Alzheimer's disease in certain parts of Wales are not getting access to drugs that may help them and which are more readily available elsewhere in the UK?

Huw Irranca-Davies: The hon. Gentleman makes a good point. That is exactly the sort of problem that the Welsh Centre for Health can tackle. However, we must be realistic. As has been noted already, once a problem has been identified, the necessary resources must be made available to ensure that it is rectified. We are committed to putting in the necessary resources. I share the hon. Gentleman's anxiety about the problem that he identified. It needs to be tackled, but that can happen only when effective resources are made available.
	There are major lifestyle problems in Wales. It would be a failure not to accept that. In Bro Morgannwyg, 32 per cent. of the population are heavy smokers, and 21.3 per cent. consume more than the recommended levels of alcohol. Only a quarter of the population undertake regular exercise, and 53.8 per cent. of people are overweight or obese. Those are staggering figures. This Bill, which has been worked out jointly, gives us a chance to identify and tackle the problems involved.

Hywel Williams: Would the hon. Gentleman have welcomed a provision banning smoking in public places?

Huw Irranca-Davies: I certainly think the issue should be tackled. I was going to mention a report that came out recently, of which the hon. Gentleman may know. It examines the regularity of drug use by youngsters, comparing that with the way in which alcohol has already entrenched itself in our societies.
	My hon. Friend the Member for Vale of Clwyd (Chris Ruane) mentioned research on a ward-by-ward basis. The WCH should consider that. I am thinking of the way in which the Xcommunities first analysis was carried out, and the way in which we have looked at communities in terms of multiple deprivation. We should consider wards as well as the bigger county, borough and health authority areas. We need to pinpoint the evidence that will enable us to tackle some of the problems.

Julie Morgan: Is my hon. Friend aware of the Townsend report, produced by the Welsh Assembly? It gives details of inequalities in health authority areas.

Huw Irranca-Davies: I know of the report, and I think that we should adopt the same approach. It is no good simply looking at one area. My constituency contains areas of relative prosperity and good health, but the picture is different when it is broken down into not just individual towns and villages, but parts of those towns and villages. The contrasts are stark. I hope the WCH will extend the Townsend approach.
	Brynawel house, an institution funded by charitable donations, is the only residential completely Xdry house in Wales that will tackle drug and alcohol abuse. It is the only institution with a policy forbidding any consumption of alcohol or drugs, and it is in my constituency. I suspect that the WCH will also increasingly consider that approach. How can Welsh solutions deal with such problems?
	I have mentioned lifestyle problems. We should adopt a more innovative attitude to issues such as GP referrals and exercise on prescription. Not everyone wants to trot along to the leisure centre rather than being prescribed a bottle of pills, but exercise is not only good for physical health; time and again, it has been shown to have an impact on mental health. I have quoted some worrying figures in that context. We should end reliance on drugs, and turn to prescriptions that tackle lifestyle issues.
	We need to get the balance right between repair and prevention. The Assembly is already starting to lead the way in devoting resources and talents to the prevention of illness rather than NHS repair costs.
	Health Professions Wales should be broadly welcomed. I expect it to have an impact on standards of nursing, midwifery and radiography. I should declare an interest: my wife works as a radiographer. I see colleagues representing mid-Wales constituencies on the Opposition Benches. They will have their own constituency problems relating to midwifery provision in remote rural communities that are some distance from district general hospitals. Unique circumstances require different solutions.
	I want to ask some questions. I am concerned about overall standards, particularly in regard to recruitment from overseas. I was pleased with what I took to be an Opposition welcome for the current recruitment, and a wish for the problems to be eased along with maintaining the appropriate standards. HPW could have a major input. I recently went to Madrid with a number of colleagues, and observed some very good schemes enabling British hospitals to recruit well-trained Spanish nurses directly. The problem is ensuring that they meet our standards and deal with our problems as quickly as possible. One of our problems, of course, is the number of vacancies that we cannot fill. As an Opposition Member pointed out in the Welsh Grand Committee, that reflects the investment that we are making; but we must fill those vacancies.

Nigel Evans: I welcomed the fact that the vacancies were being filled, but was alarmed by the fact that there were still 750 in Wales.
	Perhaps HPW should also consider the problem of retaining nurses. When I discussed it with the Royal College of Nursing, I was disturbed to learn that so many people, after three years of training, ended up earning 15,000 a year as staff nurses when they could earn more as managers in McDonalds.

Huw Irranca-Davies: I do not think that the long-term solution to the staff shortages that exist in many areas is recruitment from overseas, although it may be part of the solution. You are right: we need to develop in-house training, and the Spanish example I gave is relevant here. Those people were experiencing the reverse of our circumstances. They invested for a long time, and now have a glut of staff. Oh that we were in that position! Anyway, you are right. We must look at retention, training

Mr. Deputy Speaker: Order. May I remind the hon. Gentleman to use the correct parliamentary language?

Huw Irranca-Davies: Thank you, Mr. Deputy Speaker. I am still learning on my feet, as it were.
	The same approach by HPW might help us to deal with the shortages of NHS dentists, and, amazingly, with the shortages of GPs. In Pencoed in my constituency, which has a large population, it is impossible to recruit more than one GP per surgery rather than the four who are needed. That seems absurd, given that the area is part of the M4 corridor. HPW could play a pivotal role in pinpointing shortages and trying to deal with them.
	Let me say something about community health councils. I am glad that local patients and other local people are to be given a democratic voice. I do not agree that the proposals will lead to confusion; I strongly suspect that people will know exactly where to turn.
	My hon. Friend the Member for Clwyd, South (Mr. Jones) mentioned time off for public bodies. I hope that the Government will clarify that in their response to the Committee. They have already said
	XFurther consideration will be given to approaching the relevant Secretary of State to make an order
	which would extend the power, but I should like more clarification. We must not discourage people from becoming members of CHCs by failing to give them enough time off. I think that the Government have a will to make the system work.
	I acknowledge the extension of powers allowing CHCs to inspect local authority premises, primary care premises and, to a degree, nursing homes, but I want to know why that does not apply to prisons and young offenders' units. As I said in the Committee, that would not replace lay visits, but it would constitute a welcome extension of medical expertise and of patients' rights.
	I want to say a little about cross-border co-operationcrossing Offa's dyke, if you will. The Government have said that no review is necessary and have given their opinion, but are they adamant that their proposals will work? I am not in the same position as the hon. Member for Montgomeryshire (Lembit pik) and his neighbour in Powys, the hon. Member for Vale of Clwyd, but constituents of mine certainly travel not to Bristol but all the way to Hammersmith for cardiac surgery. So it is a matter of concern, and I seek the Government's reassurance that what they said in response to the Committee's recommendations will work.

Roger Williams: The hon. Gentleman raises the interesting point of people accessing district general hospitals outside their CHC area. We have experienced differential waiting lists, with people in Wales having to wait longer for treatment for the same condition than people in England. We believe that CHCs could play a vital part in resolving that problem.

Huw Irranca-Davies: I welcome those comments. I am sure that the Minister is listening avidly and hope that he will give a suitable response that reassures the hon. Gentleman.
	I welcome the schedule 7A changes on CHCs which allow the National Assembly for Wales to determine the membership regulations. I do not agree that that will mean that the CHCs are hidebound by what the Assembly tells them. The Assembly is setting the rules by which they work, but the CHCs have great independence within those: they will make their own representations and investigations; they will represent the views of their patients and committee, as opposed to saying what the Assembly tells them to say. There have to be some rules and regulations, but the CHCs still have a great deal of independence.
	In conclusion, I welcome the Bill, not only in terms of the beneficial impact that it will have for health provision in Wales but for the precedent that it sets for co-operative working between the Assembly, Westminster and other partners.

Bill Wiggin: I begin by paying tribute to the Chairman of the Welsh Affairs Committee who has guided us through the proceedings on the Bill so far with great skill and diplomacy.
	I am sorry that the Government's response to the Committee's proposals have been less positive about the CHCs than other issues. On time off, for example, the Government stated that it could be done by orderwhich is not in disputebut that does not mean that it can be done only by order, as might happen under the Bill. The Government's reply on coterminosity seemed to address the case against exact coterminosity, which the Committee did not recommend. Instead, it recommended a statutory duty to have regard to the local health board and other boundaries that could readily be achieved.
	The Government's reply regarding other bodies states simply that the current proposals strike the right balance. The Committee did not suggest that they did not, but that the National Assembly for Wales should be empowered to extend CHC remits if it wished to in the future rather than have to return to Westminster to seek such powers.
	The Government agreed to the Committee's recommendations on claritywhat it called the
	Xarcane language in sub-paragraphs (g) and (h).
	However, that remains.
	The Committee wanted to ensure that the National Assembly would be free to allow CHCs to commission others to carry out the independent advocacy services. The Government's reply does not make it clear whether the Bill allows that, or whether they wish it to do so. The Government agreed to review the terms of the schedule to ensure that the Association of Welsh Community Health Councils provided a system for CHCs to report to the AWCHC, but not to limit the functions that the Assembly could give the AWCHC. Again, nothing seems to have changed.
	The Government accepted the principal point that the independence of the Wales Centre for Health should be more apparent on the face of the Bill, although no equivalent to the Food Standards Agency was suggested. The bald power of the Assembly to direct the WCH has been replaced in paragraphs 6 and 7 of schedule 2, which allows the National Assembly to give directions where it believes that there has been a serious failure by the WCH to perform any function that it considers should have been performed. That presumably applies to things that have not been done rather than those that have been done, but the distinction may be unclear.
	Finally, the Government seem to have accepted the thrust of the Committee's concern that the ambit of Health Professions Wales should not be allowed to spread. However, clause 4(2) and (3) does not make it clear whether the functions to be confirmed by the Assembly order are to be restricted to health care staff. I will come to possible amendments at the appropriate stage. By and large, the Bill is benign, but one or two amendments on these subjects in line with the Committee's recommendations might be helpful.
	The Bill could have addressed the excessive bureaucracy involved in the reform of the NHS in Wales. I have heard it said that Wales will have the most bureaucratic health service in western Europe. In addition, an NHS Confederation survey found that 80 per cent. of NHS managers did not believe that the Government's reforms of the Welsh health system would work. Nick Bourne, the leader of the Conservative party in the Welsh Assembly, in his speech entitled XMaking Life Better in Wales said that we should be reducing the unnecessary layers of bureaucracy building up in our health service.
	To some extent, the Bill defeats the purpose of the national health service, which is supposed to be a nationwide public service. For example, Amicus, a manufacturing trade union, is of the firm belief that
	Xprofessional standards should be centrally determined to ensure that the standard of healthcare provision is of the same quality across the whole of the UK.
	The Bill gives authoritarian and highly centralised powers to the National Assembly for Wales to abolish or alter the CHCs, to abolish or assume the functions of the Wales Centre for Health as well as to appoint its members and chairman, and to abolish Health Professions Wales. That is a great shame.
	In the Queen's Speech of June 2001, allusions were made to legislation that would decentralise power and direct resources to NHS staff. Such National Assembly authoritarianism centralises powers and allows for measures of uncertainty and unpredictability in the Welsh health system. In addition, questions have been raised about the degree of independence from the National Assembly enjoyed by the Wales Centre for Health and Health Professions Wales. The Royal College of Nursing questions HPW's independence from the Assembly. We believe that the National Assembly should restrict itself to setting strategic objectives for the NHS, which would be more helpful.
	The Bill further illustrates the authoritarian and centralised powers of the Assembly with regard to its powers over the CHCs. Proposed schedule 7A gives the Assembly powers to make regulations concerning CHCs' proceedings, staff, premises, expenses, the discharge of functions of a council by a committee and the appointment of persons who are not members of the council to such committees.

Lembit �pik: Does the hon. Gentleman accept that that is less centralised than having all those decisions made at Westminster in the sense that the Assembly is closer to the people being served by the health service in Wales, which is one of the Bill's intentions?

Bill Wiggin: The hon. Gentleman makes a useful point, but the Bill's wording does not achieve that. I should like to welcome the retention of the CHCs and the close link between the public and health service, but some of the Bill's wording is more authoritarian than it need be.
	It is regrettable that the Bill does not make provision for the creation of foundation hospitals. Another opportunity missed is that there is no provision for the creation or construction of a much needed children's hospital in Wales. I am sure that right hon. and hon. Members on both sides of the House would like to see that.

Julie Morgan: Is the hon. Gentleman aware that a children's hospital is going ahead in the University Hospital of Wales in my constituency and that the Assembly has given it considerable funding?

Bill Wiggin: I was not aware of that[Interruption.] I think that I heard one hon. Member say XObviously not from a sedentary position. I am delighted to hear that progress is being made, however, and perhaps at a later date the hon. Lady might fill me in on why all the money has not been forthcoming.
	We would have liked the Bill to include more powers for CHCs to provide patient support services, perhaps by making patient support officers employees of the CHCs. Another of my concerns is the representation of Welsh patients receiving treatment in England, which the hon. Member for Ogmore (Huw Irranca-Davies) mentioned. In Hereford hospital, next to my constituency, at least 10 per cent., and sometimes as many as 15 per cent. of the patients are Welsh. As there are shortages of funding for Welsh patients seeking treatment in England, and as waiting lists are so long in Wales, it may be necessary for Welsh patients to keep crossing the border to be treated in England, so funding must be provided.
	The Bill contains no provision for the use of the private or independent sector in reforming the NHS in Wales, or for the use of the private finance initiative, for example. Private and independent sector involvement might be usedand might be neededto address such problems as the funding of Welsh patients seeking care in England, reducing waiting lists, dealing with the care home crisis, the problem of delayed discharges and reducing GP shortages.
	Another major criticism of the Bill is that it fails to address the real crises and issues in the Welsh health service that affect ordinary patients. Assembly Member David Melding said on 18 July 2002 that
	Xthe draft Bill is substantially different to that anticipated in June 2001 and much reduced in scope.
	Among the problems that the Bill fails to address are waiting lists for both in-patients and out-patients, which increased dramatically between 31 March 1997 and 30 September 2002: in-patients by 7.1 per cent. and out-patients by 135.1 per cent. In that regard, the Government may have broken their manifesto pledge. Before the 1999 Welsh Assembly elections, they said that no one would wait more than 18 months for in-patient treatment. Given that 4,335 people have been on that waiting list for more than 18 months1,810 people more than when the original pledge was madeit sounds as if they have broken that pledge.
	Another promise that has been broken is that regarding out-patient waiting lists. The Labour party said that, by the end of its first term in the Assembly, no one would wait more than six months for out-patient treatment. However, more than 83,443 people are now waiting six months or more for out-patient treatment, compared with 25,676 in May 1999. Indeed, the South Wales Evening Post ran a story on unacceptable waiting lists for patients with regard to ear, nose and throat treatment. Adults needing nasal surgery will have to wait for between nine and 70 weeks

Mr. Deputy Speaker: Order. The hon. Gentleman is straying a little from the Bill. I know that he is talking about what is not in the Bill, but he should address his remarks specifically to the Bill.

Bill Wiggin: I apologise for straying.

Desmond Swayne: It is very tempting.

Bill Wiggin: Indeed.
	Rather than focusing on reforming bureaucratic elements of the Welsh health service, the Bill will perhaps have less direct benefit to patients than I would have hoped. It is true that we are not overtly critical of the substance of the Bill, but it would have been better had some of the failureson which I should have liked to continuein relation to some of the promises made by the Government to patients in Wales been aired.

Huw Irranca-Davies: Does the hon. Gentleman agree that one aspect of the Bill might not only look at the failures but at things that have worked, to promote best practice, in which CHCs would have a role? For instance, in Bro Morgannwg, the number of nursing and dental staff has increased and administration has been reduced.

Bill Wiggin: That sounds very positive, and I agree with the hon. Gentleman. By and large, we all want the same thing from the Billbetter care for patients. We have to identify the best way of going forward. Some of the proposals are exceptionally positive. Having sat through the Select Committee's review of what the Bill was going to contain, the hon. Gentleman will know that I have been very supportive. It would have been better, however, had one or two of the items on which I touched in my speech been included. A Conservative Assembly Member argued that for devolution to be meaningful, major reform in the public services for Wales should be achieved in Wales-only Bills. Much of the content of this Bill should therefore have been included in the National Health Service Reform and Health Care Professions Act 2002 applying to Wales. The extra part of the Bill should not have been necessary.
	The Bill's intention is to reform patient services in the Welsh health service, but it fails to address some of the most important issues to patients in Wales, such as GP shortages and massive waiting lists. By and large, however, the Bill is well-intentioned, and I am grateful that I was able to sit on the Welsh Affairs Committee.

Jon Owen Jones: The Bill has already been described as benign, modest and consensual. I agree with all those adjectives, which is why I must disagree with the conclusions of the Select Committee Chairman, who has unfortunately just left his place. Early in his speech, he suggested that the Second Reading debate on this Bill, and on other Bills, could be curtailed. It is dangerous to generalise from the particular. It is probably true that this Bill could be speeded through the House, as could any consensual Bill, but it does not follow that simply because this Bill is one with which we largely agree, any Bill introduced through this procedure would command similar levels of agreement. I would therefore caution against the Government taking the Select Committee Chairman's word that the House agrees with rushing through all such Wales Bills.
	The philosophy that appears to be emerging in the provision of health care in Wales, as compared with the provision of health care in England, seems something of a diversion in terms of how patient empowerment is to take place. I am sure that all Members will say that they want patients to be given more power over their health care needs. It does not follow, however, that that goal can be achieved in only one way.
	This Bill and other proposals made in the Welsh Assembly attempt to empower patients by creating committeesin this case, community health councilsthat are as representative as possible to give patients greater power. I interpret what is happening in England as an attempt to give patients more power to choose their health care by giving hospitals greater independence, and by giving patients greater opportunity to choose where they seek their health care. There are arguments to be made in favour of both systemsI put it no more strongly than that, as I am being loyalbut we must try to make sure that both systems work as well as possible.
	I am in favour of community health councils being made as independent as possible in Wales, because their role in Wales will be extremely important in ensuring that patients are given health care that is adequate to their needs and what they desire, and because it should be seen to be independent of the role of Government. I therefore approve of the measures in the Bill, and I might wish to strengthen them to give independence to the community health councils.
	I would like the CHCs to be given possibly greater powers than those provided in the Bill. We need to do more than simply look forward to the role that they should have in relation to what used to be available. Tomorrow, the House will debate a Bill for England and Wales that deals with delayed discharges and the problem of bed blocking. CHCs exist in Wales, but not in England, and they could be given an important role in determining what constitutes bed blocking and whether beds have unnecessarily been taken up by people who should be discharged from acute hospitals. They could also determine at what point charges should be laid on local government to pay for the beds that are being occupied.
	That issue is extremely important in Wales, and more important there than it is in England. On any one day in England, 5,000 beds are taken up inappropriately because social care cannot, for one reason or another, be provided. On any one day in Wales, 806 beds are taken up. I calculate that, per capita, the problem is at least two to three times worse in Wales than in it is England. That fact alone explains in large part why waiting lists figures in Wales are so much worse than they are in England.

Lembit �pik: Does the hon. Gentleman agree that CHCs will be able to make a positive impact on the difficulties that he has rightly described if, and only if, there is a degree of homogenisation and shared responsibility between local authority budgets and health budgets?

Jon Owen Jones: In effect, the Bill dealing with delayed discharges will do that. When people are lying in bed in a hospital, their care is being paid for from the health service budget. When they are lying in bed in a nursing home or a community home, their care is being paid for by the local authority budget. There is a vested interestI put it no higher than thatfor local authorities to be not too quick in moving someone out of a bed for which they do not pay and into one for which they pay. The delayed discharges Bill will allow the budget to be transferred if the bed is used for social service rather than acute health care reasons.

Julie Morgan: Does my hon. Friend agree that the mechanisms for dealing with this problem have already been set up by the Welsh Assembly in the partnership arrangement that has been created between local authorities and health bodies, which looks to solving the problem jointly rather than to considering penalties on one or other of the bodies?

Jon Owen Jones: I do not agree. I hope that that might happen, but we must accept that, if the partnership agreement had been effective, it would already hopefully have had some effect. I have already explained that the position in Wales is two to three times worse than in Englandso it appears that, so far at least, partnership has not delivered. It may deliver in the future, but the legislation for England and Wales will enable provision to be made on both sides of the Severn.

Julie Morgan: I agree with my hon. Friend that the Bill coming before the House tomorrow will enable the Welsh Assembly to take advantage of what exists. However, the Assembly and local authorities have not been working in partnership for long enough to enable us to judge whether we should penalise local authorities when beds are blocked. Enough time has not yet been spent on the partnership solution.

Jon Owen Jones: Local authorities are not automatically penalised. They are penalised only if they do not deliver. If the partnership arrangement works, they will deliver and will not be penalised. Everyone will be happy, and waiting lists will fall considerably.

Ian Lucas: Is not the great hope that local health boards will create a closer working relationship between local authorities and the health service and that that will address the problem that my hon. Friend has so eloquently described?

Jon Owen Jones: I agree that we should all live in hope to some extent. The provisions will be there in case hope is insufficient, but they are important. The CHCs will also have a valuable role, especially if my hon. Friend the Member for Cardiff, North (Julie Morgan), who may be well informed about the view of the Welsh Assembly, is correct. If Wales and England take a different view of delayed discharges and if delayed discharges are not penalised in Wales, the CHCs will have a particular role to play. I can imagine the interesting and difficult issues that will need to be sorted out if the Welsh Assembly chooses not to invoke the procedure. An English hospital, such as that in Shrewsbury, which treats many patients from mid-Wales, will be able to charge local authorities in Powys and Montgomeryshire, while a Welsh hospital such as the Royal Gwent will be unable to charge English local authorities such as Gloucestershire for delayed discharge. CHCs will have much explaining to do to their patients about why such a position has arisen.
	I welcome the role that the CHCs will play. I look to them to be as independent as possible and to take on new powers as they become available in the legislative programme before us for the rest of this Session. I hope that the CHCs will be able to ensure that there is the patient empowerment that we all want and that they will do such a good job that Welsh patients will not feel the need for choices that may be available in England but not in Wales.

Hywel Williams: We are having an interesting and constructive debate. I commend the remarks of the hon. Member for Cardiff, Central (Mr. Jones) and his support for the CHCs. I also commend the remarks of the hon. Member for Ogmore (Huw Irranca-Davies) about the effect of mental ill health and the relative neglect that that subject has received.
	Referring to the Bill in his press release for the Queen's Speech, the Secretary of State said:
	XPatient power will be our watchword in the future.
	Patient poweror rather patient power, carer power and community powerhas for many years been the watchword of the most progressive elements in the health service, but they have often been frustrated by the centralisation and hierarchical structure of the system and by the strongly hierarchical nature of medical power.
	There is a glaring and long-standing need to reduce health inequalities in Wales. As page 9 of the recent Welsh Assembly document XWell Being in Wales notes:
	XAverage life expectancy in some parts of Wales is five years less than in others.
	That is a startling geographical difference. The document goes on to state that there are marked differences between different social groups. We have known about those class differences for many years and they have often been neglected. Discussion about them has sometimes been thwarted, as notoriously happened under the tenure of the right hon. Member for Wokingham (Mr. Redwood) when he served in the Conservative Government.
	A cross-cutting approach is sorely needed in Wales. It needs to consider poverty, housing and other issues, such as smoking and the consumption of alcohol. I hope that the Bill will help to expose those differences and to keep them in the minds of people who make and implement policy, irrespective of the long waiting lists and the lack of dental treatment that other hon. Members have mentioned.
	It has been said that the Bill is largely uncontroversial. Even the House of Commons Library research paper says that. Some hon. Members will recall King Vidor's 1938 film XThe Citadel. I am sure the previous Secretary of State will. In that film, part of the answer to a public health problem was the selective use of high explosives. The Bill may be largely uncontroversial, but the proper implementation of patient, carer and community power is the metaphorical high explosive we need to attack the historical inequalities of health in our country and to provide Wales with the world-class health service that the Secretary of State says it is his ambition to achieve.
	Patient power has to be enabled. We will look for a practical demonstration of the growth of that following the implementation of the Bill and other measures. We welcome the provisions that will extend the roles of CHCs to the primary sector and nursing homes. That will provide a statutory basis for the patient advocacy service and will establish a Welsh body for CHCs. We welcome the intention to create the Wales Centre for Health, which will provide public health advice, research and training support, and Health Professions Wales, which will discharge the Assembly's functions on the education and training of health care professionals and health care support workers. We also welcome the education and training functions of the Nursing and Midwifery Council and the Health Professions Council in Wales. All that is to the good.
	We hoped that the Bill would contain other proposals, such as the banning of smoking in public places, which would have made a substantial contribution to the improvement of public health. I was glad to hear the hon. Member for Ogmore agree with that. We were also keen for the Bill to contain provisions on free personal care for older people, which would create a simpler and more coherent structure, to say the least.
	However, we welcome the Bill as a specific Welsh Bill, with its process of discussion and scrutiny in both Cardiff and the Welsh Affairs Committee. We look to the fulfilment of the Assembly's pledge to provide draft regulations by the Standing Committee stage. We trust that that entire process will demonstrate clearly that the representatives of the people of Wales are well able to handle the legislative affairs of our country.
	On the particular proposals for CHCs, we are very supportive of the retention and strengthening of CHCs in Wales. We are glad that that course has been taken for our countryas glad as some hon. Members from England are envious of us and unhappy about the course set for their CHCs. The CHCs will hopefully be independent of vested interests, which relates to a point made by the hon. Member for Cardiff, Central (Mr. Jones). That is essential. We trust that the independence will not be diluted by the proposed changes in the organisation of CHC membership.
	I know from the case of my own CHC in North Gwynedd that the local authority representatives are wholly committed and valuable members. Perhaps they will join the CHC by other means. However, in rural and dispersed areas there is a limited number of such individuals. We cannot afford to ignore those public-spirited and committed people. The hon. Member for Clwyd, South (Mr. Jones) referred to the importance of taking time off work. I agree entirely.
	The extension of CHCs' role to the primary sector and to nursing homes is welcome. Clearly, CHC visits to NHS premises where care is being provided will be a valuable addition to the important professional inspection. We will look with interest at the draft regulations produced by the Welsh Assembly Government for the Report Stage on matters such as unannounced visits, but obviously those are to be welcomed as a development of patient and carer power. I do not share the concern expressed by the hon. Member for Ribble Valley (Mr. Evans) on the Assembly's power to draft the regulations and the powers given to it throughout the Bill. Irrespective of the value or virtueor otherwiseof the Labour-Liberal pact in Cardiff, we are happy for those decisions to be taken in Wales.
	Hon. Members have mentioned the fact that some Welsh patients receive their care in England. The names Gobowen, Christie, Alder Hey and Clatterbridge are familiar to patients from north Wales and their carers, who are also familiar with the high standard of care provided by those institutions and the difficulties that arise from accessing care in them. Only the other day I was made aware of a case in which a referral of a child from a specialist unit at Alder Hey to a local hospital for occupational therapy was refused because the list was closed, not because it was long. CHCs should have information about care from establishments over the border so that they can perform their duties well.
	A particular concern is the availability in English establishments of people who can speak Welsh, especially in cases that involve children, people with chronic conditions or brain injury, and the terminally ill. We particularly welcome the proposed statutory basis for the role of CHCs as patient advocates. Some CHCs already have a discrete patient advocacy service, but others do not. The welcome extra funding announced the other day will be used in my area to employ a patient advocate for the first time. I hope that that will lead to a substantial improvement in the service provided.
	I particularly look to the work that I expect the CHCs to undertake as part of patient advocacy to push for the extension and development of services through the medium of Welshand, for that matter, through the medium of languages other than Welsh and Englishin our locality and throughout Wales. The establishment of proper and good communication between the patient and the health care worker is essential, and that means that communication needs to take place in all the languages used widely in Wales.
	If patient power is to mean just that, there must be a sustained effort over an extended period to recruit people with the appropriate language skills. Being able to converse with patients in the language that they find most congenial is a core skill for some staff in some areas and for the majority of staff in others, especially if the patient is young or elderly or has suffered a stroke or brain injury. I know that some hon. Members have family experiences of the health service's deficiencies in that respect, and I trust that they will support the CHCs in pressing for change, as I sincerely hope the CHCs will do.
	The establishment of a national body for CHCs has been welcomed by the CHC representatives whom I consulted before the debate. The relationship with individual CHCs in respect of the performance management function will have to be approached in a supportive manner, and I understand that that is the standpoint of the new body. I note from the research brief that the Welsh Affairs Committee called for greater clarity as to how the new body's powers would be strengthened, and that the Government agreed that the wording of the schedule would be reviewed, but no change has resulted. Clearly the House may turn to that topic on Report.
	On a lighter note, I understand that the body is to be known as the Association of Welsh Community Health Councils, or AWCHC, an acronym already used by an hon. Member on these Benches. The health world is blessed with many and varied acronyms, which exclude and sometimes confuse even those who are used to them, let alone the patients. I had a brief look at the back of the report by the Welsh Affairs Committee, and saw the WCCPH, or Welsh Combined Centres for Public Health, the WCH, or Wales Centre for Health, and the ATM, After Today Management. I always thought that ATM stood for automated transaction machine.
	May I suggest, therefore, that the Welsh title of the new body is to be preferred, in acronym form at least, in that it yields an acronym that combines accuracy with at least a suggestion of the function of the new body? Welsh-speaking Members will realise that Cymdeithas Cynghorau Iechyd Cymuned Cymru becomes CCICC, or CICan essential attribute for a patient advocate. I hope that the CHCs, and the national body, will have CIC.
	On the Wales Centre for Health, we welcome the establishment of a Welsh body to act as a multi-disciplinary advice forum. Hopefully it will draw attention to the many causes of ill health and the many ways of tackling issues of health, poverty and housing. The body will also disseminate research, particularly Welsh data, the lack of which has, for many years, been a problem to many people working in health and social services. It will support training in sustainable health and liaise with UK and international professional groups. We have much to learn from professional groups over the border and in other European countries. Sometimes we look with too narrow a focus for comparators. In addition, as we develop Welsh models of health provision and for the prevention of ill health, we will have much to teach the world.
	We are glad that the centre's independence is assured and that it will take an active role. It will be a virtual as well as an actual centre. Some years ago, I had the experience of setting up a national centre for training and education in social work. I regret that we invested so much in bricks and mortar and much less in the networks of people throughout Wales that would have supported that centre in the future. Unfortunately, the money went into the building.
	Equally, we welcome the establishment of Health Professions Wales, which is an ambitious move. The body will carry out the functions of the Health Professions Council in Wales relating to the continuing education and training and the clinical experience of nurses, midwives, health visitors and other health care professionals and support workers. Fears have been expressed about the loss to Wales of having new and different arrangements for the health professions, compared with England. I trust that those will be allayed by the operation of the new body.
	As I said, I come from a background of education and training of social workers. In 1985, the body responsible for that, the Central Council for Education and Training in Social Work, consisted in Wales of one person coming over from Bristol to work half a day a week, sitting by the phone waiting for a call. As Members can imagine, he had very little business. The CCETSW developed into a fully fledged body, and when it was wound up, it had its own policy documents and publication programme. It also had professional staff and a training agenda complementary to that in the UK. That agenda covered all aspects of training, including, importantly, Welsh-medium training. After 17 years we see the value of that sustained development for the CCETSW, because we have a Welsh body for social care that is a fully fledged, separate entity. That was a processa long oneand not an event. I therefore value the role of Health Professions Wales in developing high-quality training, Welsh careers information and senior practitioner posts.
	On the retention of staff, we have to make sure that we recruit people who fully understand the profession, and we should be careful to promote work-based learning. I note from the research document provided by the Library that the acting chief executive of HPW sets out, as a function to be developed, advice on work-based learning. That is essential if we are to foster a climate in favour of training. People must be able to take up training while they are working. That will be important for the retention of staff.
	The use of Welsh practice as a model for developments throughout the UK is also important. I referred earlier to developing medium and practice in Welsh and other languages. We have a great deal to teach other parts of the UK and the world. We have an opportunity to experiment and to develop proper practice to give the user of the service the power to choose the language. We should be confident that we can do the research and development work and that we have something to boast about.
	I spoke earlier about the metaphorical high explosive that we need in order to attack the historical inequalities in health in our country and to provide Wales with the world-class health service that it needs. That will be hugely difficult and, no doubt, controversial. I also mentioned the widely held view that the Bill is uncontroversial. If it leads only to uncontroversial change, it will not have contributed sufficiently to the change that is needed if we are to achieve a healthier future for all the people of Wales.

Julie Morgan: I am pleased to be given the opportunity to speak on this Second Reading. I am pleased that there is a Wales-only Bill in the Queen's Speech, following the Children's Commissioner for Wales Bill in an earlier Queen's Speech. Taking into account the Welsh clauses in other Bills, we can see that the devolution settlement is working, as many hon. Members have said tonight.
	It is interesting that the Bill, along with the Welsh clauses introducing reform of the health authorities and the creation of local health boards in an earlier Bill for England and Wales, is helping to develop a distinctive way forward for the NHS in Wales. The first parts of both the Wales-only Bills, on the children's commissioner and on health, were initially included in legislation for England and Wales.
	The children's commissioner began in the Welsh clauses of the Care Standards Bill, and the reform of the health service began in the National Health Service Reform and Health Care Professionals Bill. In both cases, that allowed the proposals for Wales to start moving. The children's commissioner was able to begin work before the full powers were finally conferred on the post by the Wales-only Bill, and the health boards were included in earlier legislation so that they could be set up and staffed by April 2003. I understand that they are on course to achieve that.
	The Health (Wales) Bill has already had pre-legislative scrutiny by the Welsh Affairs Committeethe first time that that has happenedand by the Health and Social Services Committee of the National Assembly. I attended a sitting of the Health and Social Services Committee, which I found an interesting and unique experience. In that sitting, members of the Committee raised the issue of smoking, saying that a ban on smoking on public places must be part of the Bill. Everyone in the roomevery member of the Committee and those who were there observing itstrongly agreed that we all wanted a ban on smoking in public places, but it was also agreed that that did not lie within the scope of the Bill. None the less, I want to register my hope that we will get a ban on smoking in public places and that it will be dealt with as a priority. The emphasis in health should be on prevention, and smoking causes such a huge bill for the health service and such misery in people's lives that we have a duty to do what we can about it. I accept that it is not within the scope of the Bill, but I am glad that we have marked up the fact that we must do something about smoking.
	The Bill is short and generally uncontroversial. There has been some controversy in England about the removal of the community health councils, and it is good that we in Wales have avoided that controversy by aiming to strengthen and build on the existing CHCs and increase their advocacy role. The performance of that role has varied throughout Wales. The CHC in Cardiff has played a strong advocacy rolemany people who have come to my surgery to discuss problems in the health service have been helped to an enormous extent by the CHC. Cardiff CHC has had special funding to help it in its advocacy and complaints role in respect of individuals, but that does not extend throughout Wales. CHCs in other parts of Wales have not been so well funded for advocacy and complaints functions, so I am pleased that the Bill will ensure more uniform provision for CHCs and that they will be strengthened throughout Wales.
	It is interesting that England decided not to keep, change and strengthen CHCs. There seems to be a divide between attitudes in England and in Wales to CHCs. In Wales, CHCs have been thinly staffed, but there has always been a good standard of advocacy and their existence has never been questioned. As other hon. Members have said, the difference in this respect between England and Wales shows how devolution produces different outcomes. It is easy to live with the fact of different outcomesthere is no tension about Wales taking one course and England taking another. That is what devolution is and what the Bill emphasises.
	CHCs, with patients and local representatives, will work with local health boards and local authorities to create a service in which the primary aim is prevention, and the emphasis is on health, not ill health. That is the message that has been coming from the Assembly in its development of health policy: we are talking not about ill health but about health and how to create a healthy society, and that change of focus is a positive aim. Many people, especially in later life, experience health problems because of their style of living in youthsmoking is a prime example. CHCs and the health boards will play a vital role in spreading information, for example, about healthy living and ways to avoid ill health in later life. The Assembly has already done a lot of work on health promotion. If those efforts are successful, Welsh society as a whole will be healthier, which will help the health service by lessening the drain on health service resources and on the community caused by people who become ill later in life as a result of their lifestyle choices. I do not criticise those choices, but that is what happens and we have to tackle the problem.
	It is important that CHCs reflect the society they serve. I was pleased to see in their response to the Welsh Affairs Committee's report on the draft Bill that the Government acknowledge the need to ensure that CHCs appoint members who
	Xbring . . . a wide range of skills and experience, drawn from a variety of backgrounds.
	Until now, local authority representatives have made up half, and the voluntary sector one third, of the membership of CHCs, with the other members drawn from various sources. Now, it will be up to the Assembly to decide the composition of CHCs. I hope that a strong effort will be made to encourage people from a wide range of backgrounds to come forward, in particular people from less privileged backgrounds, so that we will have input from the whole spectrum of Welsh society. I hope that there will be representation from the black community and other ethnic minority communities.
	I strongly believe that young people's voices should also be heard. I do not know precisely how that will be achieved, but we must get young people involved in CHCs and their advocacy role. We have had a huge problem with advocacy services for children in Wales since the loss of the Children's Society and the advocacy services it provided. Somehow, we must find a way to ensure that CHCs can speak for young people and children. The Children's Commissioner can work to determine what young people want from the health servicein fact, the commissioner has already done some work in that respect, by examining what sort of health service provision certain groups of patients want, but I think that the CHCs should take on that role in relation to young people.
	It is important that work on a CHC be recognised as a public duty. In their response, the Government say that
	Xthe list of public bodies can be amended by Order
	to include CHCs, but we could do that here and now, via the Bill, and perhaps we should consider doing so.
	As hon. Members have said, in Wales the link between ill health and deprivation is clear for all to see. People in areas of severe deprivation suffer from bad health. In recognition of that, the Townsend report, commissioned by the National Assembly, suggested a funding formula that placed particular emphasis on funding, within as well as between health authorities. It is important to recognise that in a time of growth in health spending, it is possible to redistribute money. The Assembly is implementing the formula changes in the Townsend reportthe formula needs some refinement, but the broad thrust of the Townsend report is being implemented. As the health budget grows, every area gets an increase, but the most deprived areas get a bigger increase, and the main beneficiaries are the areas where need is greatest. I applaud the Assembly for taking that step to tackle the health inequalities that are so obvious in Wales.
	I hope that the Wales Centre for Health, when it has been set up, will take the Townsend proposals further and work towards ensuring that tackling health inequalities is seen to be the way forward in Wales. The huge differences in the health of the people in different parts of Wales are key issues that must be addressed. The Townsend report addressed the problem, and its recommendations are being implemented, but the creation of the Wales Centre for Health will be of enormous help.
	The Townsend report set out two strategies: first, the change in the formulathe redistribution of money; and, secondly, tackling the causes of ill health, which involves all the other services that contribute to the well-being of the population. Because health is linked so strongly with poverty and the vital services that local authorities provide, I strongly support the proposals in previous legislation to make the health boards coterminous with local authorities. That is absolutely right. There has been some criticism that the authorities are too small, but if they are, it is because of what the previous Government did when they reorganised local government and that is what we have to work with.

Lembit �pik: In Powys, it is the other way roundthe local authority area is too large. While I agree with the sentiment expressed by the hon. Lady, does she agree that we must bear in mind the size of local authorities to try to avoid complicated cross-cutting for community health councils?

Julie Morgan: Yes, I agree.
	If we look at inequalities which cause ill health, housing and access to leisure facilities have more of an impact on the health of the nation than, for example, the prescribing of drugs. I wonder whether hon. Members read press reports yesterday of a study which showed that pensioners in Japan live longer if they live near parks and tree-lined streets in cities? The study showed that less noise and more natural light in houses were associated with long life. The more active an older person, the longer they tend to live. We should look at those crucial points when we provide health care. A huge benefit of free bus travel for pensioners in Wales is that they will live longer because they are getting out and aboutthat is a vital impact on the health of people in Wales.
	The provision of public parks is important. In Cardiff, we have wonderful parks. Bute park is adjacent to my constituency of Cardiff, North, and the Taff trail passes through it. Those opportunities for leisure and health are as important as the services provided by the NHS. The two issues are closely linked. I am therefore pleased that existing legislation makes provision for local authorities and health boards to work together closelyon the boards themselves, of course, there will be local authority representation. In our pre-legislative examination of CHCs, we discussed whether their boundaries should be strictly coterminous with those of the health boards. The Select Committee's conclusion was that that was best left to regulations by the Assembly, following consultation. There were strong views about not restricting boundaries too much, with which I agree. It is best to consult, as CHCs have already gone through reorganisation and uncertainty, and different issues arise in different parts of the country, as the hon. Member for Montgomeryshire (Lembit pik) mentioned. We should not be prescriptive, so I support the view that the Assembly should make a decision and introduce regulations.
	The Bill plans to extend the CHCs' remit to primary care nursing homes, which is a good move. The Prison Service issue needs to be looked at again. I am concerned about the provision of health care in prisons, and an overseeing body is needed to look at standards. I support the creation of the Wales Centre for Health and Health Professions Wales. I welcome the fact that Wales will take the lead on the inclusion of health support staff. The Select Committee on Welsh Affairs discussed the way in which such an inclusion would be different from practice in the rest of the UK, and we in Wales should be pleased that we have acknowledged the importance of health support staff.
	The Welsh health agenda is preventive and radical. Measures already introduced, such as the freezing of prescription charges and free prescriptions for the under-25s, by the Assembly will result in long-term benefits. We do not know what the long-term effect of such measures will beperhaps the Wales Centre for Health can analyse the effect of their early introduction. For example, if young people have access to free prescriptions, that may have long-term benefits. I am pleased that the Minister for Health and Social Services in the Assembly has said that there is no intention to go down the route of foundation hospitals, which were included in the Queen's Speech.
	One of my concerns about foundation hospitals is the fact that they could choose to pay their staff more. We would get into a situation where one hospital would be out-bidding another, and I fear that health would suffer generally as a result. It would be unfortunate if an auction were to take place between different types of hospitals. I am therefore glad that the NHS in Wales is not going down the route of foundation hospitals.
	It is important to retain a national pay scheme for nurses in England and Walesif there was a variation in Wales, we would end up being out-bid. Also

Mr. Deputy Speaker: Order. The hon. Lady must resume her seat if I am standing. She is now roving rather wider than the terms of the Bill and must come back to order.

Julie Morgan: Thank you, Mr. Deputy Speaker. I am sorry if I roamed from the Bill.
	In conclusion, the Bill is a small step towards achieving the Assembly's goals of prevention and a healthy Wales. The pre-legislative scrutiny was a beneficial process, and I look forward to the Bill's remaining stages.

Roger Williams: It is a great honour to follow the hon. Member for Cardiff, North (Julie Morgan), who has done a great deal of good work on behalf of children in Wales. I noted her remarks about the membership of CHCs and the way in which we could better reflect the needs of children. I shall return to that later.
	We support the Bill wholeheartedly. It is a small and devolved step towards a better national health service in Wales. Those of us who want a thoroughly improved NHS in Wales know that that cannot be achieved at a stroke, but step by step, inch by inch. Waiting lists have been mentioned, but they are an inappropriate measure of the success of a health service. The Bill is about patients and patient power, but it does not matter to the patient whether he is first on the list or 10,000th. What matters is when he is going to get his treatmentthat is the key issue for individual patients. We are in danger of sinking into a morass of statistics about the NHS and losing sight of the fact that it should provide a personal servicepeople desperately want to achieve that.
	I was going to give another accolade to the hon. Member for Clwyd, South (Mr. Jones) who was in danger of receiving so many that it would be impossible for him to leave the Chamber. However, he has leftprobably because he is afraid of having so many accolades. It was a privilege to serve on the Select Committee on Welsh Affairs, which undertook pre-legislative scrutiny of the Bill. Particularly impressive was the way in which the public and health professional in Wales were involved in that process. As a result, many of the Select Committee's recommendations were accepted and the Bill has achieved its Second Reading. The hon. Member for Clwyd, South said that we could have a truncated Second Reading because many issues had been teased out and put to bed. One that springs to mind is the title of the Bill. It started off as the National Health Service (Wales) Bill, but it quickly became apparent that CHCs, the Wales Centre for Health and Health Professions Wales could deal with health care delivered by agencies outside the NHS. Quite rightly, the title has been changed, and the Bill is now the Health (Wales) Bill. That is a minor issue, but it demonstrates the way in which problems were identified at an early stage and rectified.
	Turning to issues raised by the Bill, I wholeheartedly agree with the hon. Member for Cardiff, North that it is appropriate that the Welsh Assembly should have a say in the way in which members of community health councils should be identified and appointedthat should be a devolved matter. Under the old appointments system, local authorities could nominate members for community health councils. We all know of local authority members who have played leading and very significant parts in the work of community health councils, as well as some who see such work as another part of their overall role and cannot give the amount of time and effort that is needed because of the responsibilities that they have in their local authority. Perhaps the Assembly will take that into consideration when deciding on membership.
	I also take on board the point made by the hon. Member for Cardiff, North about including on CHCs people from ethnic minorities and younger people. That is desperately important.
	The Bill's extension of the powers and roles of CHCs will also involve the training that members receive. The duties and expertise that they will need in carrying out the inspections and dealing with problems raised by individuals will be much greater than in the previous CHC system. When we look at the amount allocated for setting up the councils, I hope that there will be enough resources to ensure that those involved do not go out on their visits and inspections unprepared for the duties and responsibilities that will be expected of them.
	I also value the advocacy role that CHCs have exercised in the past and the greater advocacy that will be expected of them in future. I am especially interested in the work that they have done for people suffering from mental health problems. In rural areas, the importance of mental health issues is especially acute, because people tend to live in isolated locations where they do not get the family and community support that is sometimes available in more densely populated areas. Voluntary bodies are also involved in that advocacy work. Great skill will be needed when the CHCs and voluntary bodies decide between them how such work will be done to best effect for the patient.
	Mention has been made of the possible extension of the work of CHCs to prisons and young offenders institutions. That issue has been teased out in this debate and we will perhaps see more of it in future. Schools are another area in which health provision is made. Not only are there emergencies such as accidents or sudden illnesseslay people are often asked to administer medication to children who may need it during the school daybut children in school are given advice and counselling on health issues, and the quality of that counselling and advice is important in health delivery for young people.
	I should like to mention a particular initiative that my local CHC has just undertaken: the setting up of a first responder scheme in which a group of volunteers is trained to attend when somebody has suffered heart failure or a heart attack and to use defibrillators to restart heart activity. As the volunteers are based locally, such action can often be more quickly carried out than by the ambulance service. The initiative has already been set up in one area and is about to be set up in another. It is an example of how CHCs can take initiatives and drive forward service improvements, rather than merely inspect or wait for people to make complaints. Figures show that where first responders are in place, recovery from heart attacks is 10 times more likely than elsewhere. That is a very good example of how CHCs can work.

Lembit �pik: Does my hon. Friend agree that the Bill presents an especially important opportunity in that regard? He and I have both known people such as the late Hugh Taylor, who would have been alive today if such a scheme had been in place and the community health councils had had the power to implement the very important service to which he refers, especially in rural areas.

Roger Williams: I take the point that my hon. Friend makes; we both know the gentleman whom he mentioned. We have an opportunity in Wales to show what the powers and scope of CHCs can be in improving the health and well-being of people in such areas.
	I would like us to keep the name Xcommunity health councils, as access to these bodies is so important. A change of name merely makes it that much more difficult for somebody to find their way in getting the help and support that they need. We have already a successful organisation and we are going to make it better by introducing the Bill, but we should not make access to it more difficult by changing names.
	The Bill is about devolution and getting the right solutions for Wales. My hon. Friend the Member for Montgomeryshire (Lembit pik) and I have certain difficulties in respect of community hospitals that have always delivered various medical operations and activities that are now being phased out because royal colleges believe that those hospitals do not have the appropriate facilities. That is happening despite the very good safety record on delivering those services. Indeed, the population to whom the services are delivered are very satisfied with them and hope that they will continue. In the Wales Centre for Health, which could give advice on those matters, and also Health Professions Wales, which could train people to operate in such ways, we will now have the facilities in Wales to reconsider those matters and see whether such services could be delivered locally in community hospitals by doctors who want to provide them and to patients who would benefit greatly.
	A local example is Brecon hospital, which had a GP-led maternity service. Not only low-risk, but medium-risk, mothers could be delivered. However, because of advice given by a London-based organisation, that has now changed to a midwife-led maternity service of which only mothers who have been classified as low risk can take advantage. The service was very well thought of by local mothers, many of whom wanted it to be delivered locally. In some cases, however, they now have to travel 20 or 30 miles to get the level of service that they want. I hope that we can have Welsh solutions to Welsh medical issues, and I am sure that the Bill goes a long way towards achieving that.
	My hon. Friend the Member for Montgomeryshire mentioned several matters over which we would like the Assembly to have power. The first is free eye tests for everyone in Wales. In 1989, the Conservative Government introduced charges for eye tests, but the current thrust of health policy in Wales is prevention and primary health care. Free eye tests for everyone would mean the early diagnosis of the symptoms of some diseases and therefore the use of preventive medicine.
	We also support free dental checks

Mr. Deputy Speaker: Order. The hon. Gentleman is losing sight of the Bill.

Roger Williams: I thank you, Mr. Deputy Speaker, for your advice. Free dental checks are such an important aspiration for us that we sometimes get carried away when we advance it.
	The Bill will improve the health service in Wales. We thoroughly support it.

Martin Caton: It is a great pleasure to follow the hon. Member for Brecon and Radnorshire (Mr. Williams). Like him, I am a member of the Select Committee on Welsh Affairs, which was involved in the pre-legislative scrutiny of the draft Bill.
	It became clear as we took evidence that the Bill is uncontentious and has wide support across the professional and political spectrums. That was confirmed in our debate in the Welsh Grand Committee on 16 July and in the debate in the National Assembly a couple of days later. It received further confirmation this evening, at least when we focused on the Bill.
	I do not deny the importance of the Bill's three key objectives, but the different method of dealing with the measure so far and its impact on the Bill's passage is equally important. In the current instance, process may be as significant as the event. I therefore want to consider briefly what the process has achieved and whether we can learn lessons from our approach that will help in future.
	It has already been said that this is the first occasion on which a Wales-only Bill has been subject to pre-legislative scrutiny that involved Back-Bench Members in Westminster and our colleagues in the Assembly. The Welsh Affairs Committee was given the job of initially examining the draft Bill on behalf of the Commons.
	Some hon. Members, especially Labour Members, have argued that the Select Committee was not the appropriate forum for the task. Perhaps their strongest argument is that although a Select Committee is normally the best body for undertaking pre-legislative scrutiny, the Welsh Affairs Committee is different. Most Select Committees cover specific aspects of policy such as education, health and defence. The members have therefore developed expertise and have a special interest in their subject. It is argued that that does not apply to the Welsh Affairs Committee or any of the other territorial Committees, and that we need to find a different way forward for Bills that apply only to Wales.
	Although that argument contains a kernel of validity, Select Committees have greater strengths than a collegiate expertise and experience. The approach and culture that established Select Committees are more important. We proceed through investigation, seek objectivity and try to reach consensus. All Select Committees, even those that cover specific policy matters, look outside to those who give evidence and to special advisers for expertise and special interest.
	The Welsh Affairs Committee did a good job in considering the draft Bill. It would be difficult to establish an alternative body on an ad-hoc basis that could do a better job in future. The Welsh Grand Committee is too large and too party political to undertake that function.
	I was impressed by the partnership approach that developed between the Government in Whitehall and the Government in Cardiff bay in devising the measure. That was reflected in the joint session when my hon. Friend the Under-Secretary and Assembly Minister Jane Hutt gave evidence together.
	We did not achieve the same partnership between our Committee and the Health and Social Services Committee in the Assembly in scrutinising the measure. However, we made some progress and, as my hon. Friend the Member for Cardiff, North (Julie Morgan) pointed out, Assembly Members attended some of our Committee's meetings and vice versa. I am sure that we can build on that. Surely we can maintain our separate responsibilities as Members of Parliament and Assembly Members and our separate decision-making processes, but co-operate far more effectively in evidence gathering.

Julie Morgan: Does my hon. Friend agree that it would be a good idea to have joint committees comprising Westminster Members and Assembly Members, as the Chairman of the Select Committee suggested?

Martin Caton: I thank my hon. Friend for that suggestion. I think that we are a little way away from that, but it is an objective that I would seek. We could probably do that only in the evidence-gathering stage, as I suggested. For pre-legislative scrutiny, the Assembly needs to come to its own decisions separate from us, whichever forum is used to represent the Commons. Similarly, the Commons, whether in the form of a Select Committee or another body, would have to come to a decision about its recommendations independently. However, in the evidence-gathering stage, there could be much better, more effective co-operation. I hope that we will move towards that.
	The pre-legislative scrutiny at both levels of Welsh government has already proved its worth. Even on a short and uncontentious Bill such as this, we have identified scope for real improvement at the draft stage. I congratulate the Government on taking on board many of the proposals. In some cases the Government, in responding to recommendations from various parties, including the Select Committee, made a fair case for sticking to their guns. In one or two other cases, they should be pressed a little further.
	I want to return to the concerns that I raised in the Welsh Grand Committee back in July, and look at how they have been addressed in the Bill. I warmly support each of the three purposes of the Bill. I remain convinced that reformed and enhanced community councils will be the right people's watchdogs for the health service in Wales. I am sure that the Wales Centre for Health, with its advice, training and research remit, will provide independent assessment and support that will form a hub for partnership between the various sectors that provide or utilise information or evidence on health issues.
	I am equally confident that Health Professions Wales is a step forward, building on the remit of the old Welsh National Board for Nursing, Midwifery and Health Visiting to include care support workers, and allowing the inclusion of other health care professions over time.
	In July, we considered various issues that came out of the Select Committee inquiry. I welcome the fact that the short and long titles of the Bill now properly reflect the contents of the Bill. I welcome also the clarification of languages in some clauses and schedules, although I suspect that there is still more scope for improving the plain speaking part of the Bill; the inclusion of the promised reference to the rights of CHCs to receive information from health service providers; and the tightening of the wording to protect the independence and the perceived independence of the Wales Centre for Health, although again there may be further steps that we can take in that regard.
	The Government have made a broadly rational case for maintaining their and the Assembly's approach to the co-terminosity of CHC boundaries and local health boards; to some extent on the adequacy of current drafting to enable CHCs to undertake independent advocacy services; and on the powers and functions of the Association of Welsh Community Health Councils.
	I now also accept that the National Assembly's powers of direction to Health Professions Wales on functions carried out by that body on behalf of the Health Professions Council or the Nursing and Midwifery Council are already constrained by the agreements that established those functions. A requirement in the Bill for prior consultation, as we suggested, would therefore be superfluous.
	Although we in the Welsh Affairs Committee did not address the matter in our report, the National Audit Office rightly drew attention to the lack of provision for the Auditor General for Wales to carry out value-for-money investigations into the work of the Wales Centre for Health. I am delighted that the Government have provided for that in the Bill.
	That leaves me with three ongoing worries about the Billtwo that I raised in the Grand Committee, and one that the Royal College of Nursing Wales raised subsequently. First, I still believe that it would be useful if the Bill went even further in empowering the Assembly to extend the remit of community health councils to include the inspection of and the requirement for information from anyone involved in the provision of publicly funded health care.
	I still believe that the scope of CHCs should extend to prisons and young offender institutions, as has been mentioned several times today. Medical assessment and care, especially psychiatric assessment and care, in our prisons is a real issue. Although I appreciate that prisons have their own inspection and lay visitor systems, I believe that inspections by a group of informed lay people who could make direct comparison between health provision in prison and outside would be extremely valuable.
	That brings me to my other on-going concern: the fact that the Bill still does not give CHC members a statutory right of time off work for their public duties. Frankly, this remains an anomaly. Representatives of CHCs across Wales told the Select Committee that provision of this right was probably the best way of getting CHCs better to reflect the communities that they are supposed to represent. At present, younger working people feel unable to participate in the work of CHCs because they cannot get time off work or cannot afford to take that time off.
	I was a member of the old Swansea and Lliw Valley community health council for some years, and this was a real issue even then, in particular for hospital and other institutional visits, some of which, sensibly, had to be made in the daytime. During my time on the council, anyone who went to one of our regular monthly meetings in an evening would have seen a body of people who broadly reflected Swansea and Lliw Valley society in terms of gender balance, age range andto a lesser extent, sadlyethnic origin. If they went on one of our inspection visits in the daytime, however, they would have got a very different picture. Mostly, it was only retired members who were able to take part. We are now talking about extending the responsibilities of CHCs to deal with private homes and primary care providers as well as hospitals and other institutions, and the problem is likely to get worse if we do not address it. Perhaps the Bill is not the right way to provide a statutory rightit might be more appropriate to use an orderbut this change is essential, however we achieve it.
	The Royal College of Nursing Wales has raised an issue worth considering, in the briefing that it has sent to us all. It is worried about how major health service reconfigurations proposed by local health boards or the NHS Wales Department will be dealt with in practice. It foresees that, due to the small size of local health boards, big changesthe closure of an accident and emergency department is the example that it citescould be devised jointly between the local health board and the regional offices of the NHS Wales Department, which is part of the Welsh Assembly Government. In such circumstances, if a CHC exercised its right of appeal against that reconfiguration to the Assembly Health Minister, that Minister would be sitting in judgment on a proposal that had come, at least partly, from her own officials. The RCN believes that this would constitute a conflict of interest, and proposes the creation in the Bill of an independent configuration panel for Wales, to provide independent advice to the Minister. I understand that that is what happens in England. I would be interested to hear the Minister's thoughts on that proposal when he winds up. Perhaps we could return to the matter in Committee.
	This was a good draft Bill; it is a better Bill now. Who knowsperhaps it will be better still when it comes back on Third Reading.

Hywel Francis: I warmly welcome the Bill for several reasons, not least because it makes a major contribution to Welsh constitutional history, Welsh social history anddare I say it?Welsh socialist history. Most important of all, it makes a contribution to the future and well-being of the Welsh people. As a fervent campaigner for democratic devolution in Wales, I am proud to say that this is the first Wales-only Bill that has undergone pre-legislative scrutiny by the National Assembly for Wales and by this House, and as a member of the Welsh Affairs Committee, I am very proud to have participated in that process. What better first Wales-only Bill could there be than one that addresses the quality of life of our people and the health of our nation? It is also constitutionally important because it shows the benefits for Wales of the devolved and central Administrations working in partnership rather than engaging in confrontation and conflict.
	The Bill is also important because it is the logical consequence of recent social history in Wales. The retention, democratising and strengthening of Welsh community health councils is the logical conclusion of our own recent struggles, particularly in relation to democracy and advocacy. We all know that the national health service was modelled on the democratic, socialist and grass-roots principles of the Tredegar Medical Aid Society by the founder of the NHS, Aneurin Bevan, rooted as it was in all the struggles of all the valleys of south Wales and, indeed, the whole of Wales.
	More recently, that advocacy and those democratic principles have been carried forward by such pioneers as the late Dr. Alistair Wilson and his Cynon valley patients committees and by Dr. Julian Tudor Hart of Glyncorrwg in my constituency. Dr. Hart's document XGoing for Gold inspired so much of the thinking behind the Welsh Office document XBetter Health, Better Wales, which, like Dr. Hart's publication, addressed improving primary health care, democratising the health service and giving patients a voice.
	It is a tribute to the Welsh Assembly Government's Minister for Health and Social Services, Jane Hutt, her deputy, Dr. Brian Gibbons, who was at one time a partner of Dr. Julian Tudor Hart, and my hon. Friend the Under-Secretary that the Bill, which has a consensual and sensible nature, has progressed with wide public support. It addresses the central questions of NHS reform, not only in Wales but more widely. I refer in particular to the nature of local democratic accountability and ensuring that we move from what Dr. Julian Tudor Hart once described as a Xbody repair service and a Xnational disease service to a genuinely democratic and effective NHS for the 21st century.
	I commend two aspects of the Bill, the first of which is the continuation and strengthening of the community health councils in Wales. That welcome development is very much in the social justice tradition of Wales, and it is thoroughly appropriate that the CHCs have a strong democratic element that is achieved through local authority and other representation. That is a major local democratic reaffirmation and a return to the best values of the Tredegar Medical Aid Society and other similar voluntary health organisations of the past.
	The CHCs will have a significant additional advocacy role in the complaints process. We do not need a confrontational complaints procedure. The new complaints system can also provide useful feedback to service providers. We know to our cost how stressful some of those procedures can be. For example, a Gower doctor tragically committed suicide after a complaint was lodged against him last year.
	When matters proceed to a formal complaints stage, patients need assistance through a complex and difficult process that they might go through only once in their lives. I welcome the fact that CHCs will be able to have a remit on nursing and residential homes. May I make a final observation on CHCs? The public do not find that name easy to establish in their thinking as that of an NHS watchdog. No doubt the Welsh Assembly Government will address that matter through their own local consultation processes.
	The second aspect that I wish to address is the creation of the Wales Centre for Health, which will promote well-informed public health policies across Wales and from which I am sure the whole UK will benefit. Of course, we need good, reactive health services, particularly for those parts of the UK that suffer disproportionately from serious ill health, such as the south Wales valleys and certain parts of rural Wales. However, we also need informed public health policies that take on board the wider agenda of identifying the causes and determinants of good and bad health, so that people can live healthier lives in the first place.
	The A.J. Cronin novel XThe Citadel, which is based on a south Wales mining valley, has already been mentioned. Its hero performed an extreme act in taking a public health initiative and blowing up a defective sewer system. A more benign and peaceful, but nevertheless powerful purpose of the new centre is to provide independent public health information to community health groups that are concerned about the health implications of public policy. We have noticed in recent times, for example, the deep concern at Nantygwyddon Tip in the Rhondda and Crymlyn Burrows in my constituency.
	I understand that the Welsh Health Minister has pledged that the CHCs will have a statutory right to consult on major local changes in NHS provision and that she will address that matter in regulations. I believe that she is correct in doing that, as those issues should be addressed by the devolved Administration.
	The health service is entering a bright new era in Wales. Next Saturday, I shall visit a new hospital in my constituency at Baglan Moors and I am reliably informed that my first visit may coincide with the birth of the first baby at the hospitalLabour delivering once again for Wales.
	The two developments within the Billthe strengthened, democratised CHCs and the new Wales Centre for Healthencapsulate democratic devolution in practice. They are policies made in Wales in partnership with Welsh representatives here in the House. I hope that we have been true to the needs and aspirations of the Welsh people in our deliberations. The representative and advocatory nature of the CHCs and the WCH is very much in accordance with the spirit and aspirations of the Welsh founder of the national health service, Aneurin Bevan.
	I end with Aneurin Bevan's prophetic words, quoted in Dai Smith's admirable book, XAneurin Bevan and the World of South Wales:
	XThe first function of a political leader is advocacy. It is he who must make articulate the wants, the frustration and the aspiration of the masses. Their hearts must be moved by his words, and so his words must be attuned to their realities . . . A representative person is one who will act in a given situation in much the same way as those he represents would act in that same situation. In short, he must be of their kind ... Thus a political party which begins to pick its personnel from unrepresentative types is in for trouble. Confidence declines.
	I believe that that applies equally to public bodies, and for that reason the Bill enhances confidence. That is why I commend it to the House.

Wayne David: Like other hon. Members, I welcome the Bill. Although it is short, it is very significant. Unfortunately, some Membersperhaps not those who are here tonighthave been somewhat dismissive of it. I believe that the Bill will make a big difference, because the health service is one of the biggest, if not the biggest, issue in Wales today. My hon. Friend the Member for Aberavon (Dr. Francis) quoted from Aneurin Bevan's XIn Place of Fear. If something is to be put in place of fear, it should be a society with a proper health service, so that people do not have to be unduly concerned about their health.
	The Bill is important in two very real senses. First, it has constitutional significance: this is the first time that a Wales-only Bill has passed through the process of pre-legislative scrutiny. It is therefore very much a product of a constructive partnershipnot just a consensual partnership in this House, but a partnership between this House and the National Assembly for Wales. Others have described the Bill's long gestation process: it was discussed in the National Assemblythe genesis of the idea came from the Assembly; it has been discussed by the Under-Secretary of State for Wales in this House and by the Minister for Health and Social Services in the National Assembly; and it has been deliberated on by Members of both places. It was also discussed in some detail in the Select Committee on Welsh Affairs, which produced an excellent report on it.
	It was the subject of a major debate in the Welsh Grand Committee, which I am pleased I participated in. If we look back at the process to date, we can honestly say that it has provided a good model. I sincerely hope that its lessons will be learned and similar processes will be put in train.
	There is a wider debate to be had about how the House co-operates with the National Assembly for Wales. We must seek and promote greater dialogue between individual Members. We need mechanisms that bring our two institutions together. I pay tribute to my hon. Friend the Member for Wrexham (Ian Lucas) for the suggestions that he has made.
	It is worth noting that there has been a debate about co-operation with another institution, namely in the European Scrutiny Committee. The suggestion has been made that there should be a European Grand Committee, which would pull together Members of the European Parliament and hon. Members to debate issues of common interest. Perhaps we should consider inviting Assembly Members to the Welsh Grand Committee, so that they could deliberate on legislation at a pre-legislative stage. That is one of the constitutional debates that must be held and arises from dealing with the Bill.

Lembit �pik: Does the hon. Gentleman agree that the strength of the Bill and the relatively uncontroversial nature of the debate tonight is a direct consequence of stakeholders in the Assembly, together with health professionals, having exactly the opportunity that he describes?

Wayne David: There is something in that point of view. However, the material that we are debating is perhaps intrinsically uncontroversial. Nevertheless, if we are concerned about achieving a new form of politics in Wales, as has often been said, it must be done on the basis of partnership. The experience of this Bill has provided a good model to develop in future.
	The Bill, which is important for the people of Wales, essentially contains three proposals relating to community health councils, the Wales Centre for Health and Health Professions Wales. Although it is good legislation, it is not always easy to comprehend and certainly during the later stages of the Bill consideration could be given to how it could be simplified and more straightforward language could be employed.
	I should like to concentrate on the proposals with regard to community health councils. In my time as the Member of Parliament for Caerphilly over the past year and a half, I have had a positive relationship with my local community health council, Gwent community health council. Some 60 members bring to that CHC a wide range of experience. I have been very impressed with the range and quality of the work that they are engaged in. Extensive consultations are taking place on a range of services, and the CHC frequently takes up individual issues in a sensitive and responsive way for members of the public. My constituency office has developed a good and productive relationship with Gwent community health council.
	I am pleased that the Bill recognises the worth of community health councils and points the way forward but significantly the Bill is not so much about defending what we have and maintaining the status quo; it is about looking positively at how we can build on the base that we have already. That is why I warmly welcome the fact that there is scope for making our CHCs more representative than they are already. There is scope to bring a wider still cross-section of society into CHCs to make them more effective. There is a need to extend the powers of CHCs.
	I welcome the fact that there will be a more comprehensive advocacy service, covering, I hope, the whole of Wales. That network of CHCs will need to co-operate closely with other advocacy services, not least the Children's Commissioner for Wales, a post that has recently been established and has proven to be a success.
	I think, too, that we must welcome the new powers in the Bill to oversee primary care facilities. The National Assembly for Wales will be empowered to introduce regulations to allow inspections of private health premises where NHS services are deployed. I certainly welcome that: it is a small measure in terms of the relationship with the private care sector, but I am very concerned about the standard of private nursing homes in my constituency. I could cite many examples of appalling standards in those homes that would be a disgrace in any civilised society. Modest as it is, the proposed introduction of CHCs into that context will be warmly welcomed by many people.
	I share with other hon. Members the view that there remains scope to extend CHCs' role. There is a logical argument that they should be involved in prisons and institutions for young offenders. It is also worth noting that, although the allocation of extra resources of some 550,000 from the National Assembly is welcome, that amount will not be sufficient to secure true democratic accountability and effective CHCs. For that, we will need even more resources in the future, and I urge the Assembly to allocate them.
	In conclusion, the Bill is significant, both in constitutional terms and in terms of the development of the NHS in Wales. I hope that my hon. Friend the Minister will respond positively to the constructive points that have been made by hon. Members of all parties, and that the Bill will receive the House's warm endorsement in its later stages.

Dai Havard: I, too, welcome the Bill. I do not intend to deal with technicalities and cover ground that many hon. Members have covered already, but I am especially interested in the scrutiny process that has taken place. Many useful comments have been made about how the process has increased the number of people able to express a view.
	I share the concern about prisons and institutions for young offenders, and think that the involvement of CHCs could be a good idea. A long time ago, in a former life, I was a trade union official representing prison governors. I have seen some consequences of bad health provision in prisons. That provision would certainly benefit from having another pair of eyes look at it from outside.
	The cross-border problem associated with the work of CHCs has been mentioned, and I shall return to it later, as it has some important aspects. First, however, I want to say something about investment, process and patient involvement. The latter is the most important element of the Bill.
	I have different tests for the Bill. Is it really about patient empowerment? Is it really going to be a way of providing engines of change? What I require in the health service is step change as well as incremental change. There has been massive investment in the health service in Wales. By April 2004, spending on health provision in Wales will be 3.8 billion, 50 per cent. more than when the Assembly was created in 1999.
	There has been investment also in people. That is continuing, and the Bill contributes to that growth. I welcome that. Investment is going not simply to clinicians, but to the other professionals in the health team, right the way through to the ancillary workers. That is necessary, because health provision requires a team approach.
	Investment is also being made in knowledge and information, and I hope that that will allow the health service to be proactive rather than reactive. I intend to concentrate on the role of CHCs in that context. The structures of health service provision in Wales have been subject to many changes, and that process is continuing. We now have local health boards and strategic partnerships involving local authorities. They are fundamental to a holistic approach to health. I pay tribute to the managers of all those institutions in my area. They even involve themselves in crime and disorder partnerships. I celebrate the development of that strategic holistic view.
	My local CHCs do a lot of good work, but, as my hon. Friend the Member for Caerphilly (Mr. David) has said, we should do more than defend what we have; we should develop it for the future. Advocacy is important in that context. In the valleys, people often put up with services that the articulate middle classes in other parts of the United Kingdom would not tolerate, because they do not have the right aspirations. I need others to help them identify their requirements. Studies are in progress, although I understand that developing the advocacy role is proving slightly more problematic than was expected. The patient support officer schemes that are being trialled are exactly what we need.
	If we are to live up to the standard we have required from the Welsh Assemblysustainability in all things, but particularly in terms of improving health, and a holistic viewwe need helpers. The voluntary sector is very important in my constituency. A charity called Cancer Aid Merthyr provides not only transport but counselling, and other services that would not otherwise be available. Macmillan nurses are also important, and they are to become part of the facilities provided by hospitalsoncological facilities, for example. I hope those voluntary workers will be integrated in the make-up of the institutions that we are creatingor the Welsh Assembly is creating.
	Perhaps other parts of the UK can learn from the various ways of managing this process in Wales. My local trust now has public involvement liaison groups. It is a horrible title, but its intentions are good. It has already accepted the principle of extending involvement and bringing in more peoplenot the Xusual suspects, as my research assistant said to me the other day, but people beyond that definition. My hon. Friend the Member for Cardiff, North (Julie Morgan) made a good point about the need to involve younger people and previously disenfranchised groups.
	The Minister referred to the new community hospital that we are to have in Merthyr. The principles I have mentioned are being applied in the plans for that hospital. I am also very pleased that it is being financed publicly rather than through the private finance initiativebut that is another story for another day.
	I want to say something about patient involvementnot what is planned, but how it could be used. The incidence of cancer in my constituency is very high. Wales already has a cancer champion, a care strategy including a palliative care strategy, investment in specialist centres and a cancer co-ordinator. Many useful things are happening. The problem is the standards being applied, and the major frustrations encountered by those who try to make changes. As I have said, I want to test the ability of the new institutions to make such changes.
	My current worry is that cancer patients often suffer badly from fatigue as a result of anaemia, and need blood transfusions. Having investigated, I think they would benefit from alternatives to transfusion. Bed-blocking was mentioned earlier, and it is certainly one of the major problems in the health service. If patients were not having transfusions they would not be taking up hospital beds, and according to my calculations 250,000 hospital beds would be become available.
	How can I ensure that such standards operate? If change is to happen, there must be ways of seeing that. I need agents to help me. The blood service in Wales is run by the Welsh blood service in the south, while what is known as the national blood service but is actually based in England deals with north Wales. It will be interesting for the CHCs responsible for the area to deal with that problem by considering the remit of those blood service institutions. Another serious issue, as we have heard, is that some patients have to go to Alder Hey or other hospitals in England, and I ask the Minister to give further consideration to that arrangement.

Jon Owen Jones: My hon. Friend makes an interesting point about how effective specialist care could be best managed in different areas. I am sure that community health councils will be able to play a role, but surely the most effective way to develop that is to have a national audit across the United Kingdom comparing best systems and how they work. An independent database helps local people know what is the best available care.

Dai Havard: I share some of my hon. Friend's views on the audit process, but I shall not go into detail about it. He has made the point that he wanted to make.
	Setting up the Wales Centre for Health is a very important step. It will have to work alongside and co-operate with many other health institutions, for example, the National Institute for Clinical Excellence, whose remit will still apply in Wales. It will be important to judge how that arrangement works.
	I have a problem that I am trying to resolve. I have decided that I may be banging my head against the existing bureaucracy, even though I have the Chancellor of the Exchequer on my side, apparently, in doing so. So, I have turned the problem the other way around and said that what is really important is what the patients understand. I welcome the CHCs and the advocacy services. I want the informed debate that I am told should take place between clinicians and patients regarding what is the standard and the care that they should expect. I hope that these bodies will help empower patients so that they know what to ask forvery often they do not know unless someone tells them what care is available.
	I am involved with a free magazine for cancer patients. It is in the Library of the House, and it provides a forum for debate so that patients can understand what could and should be available to them. In that way, they are empowered and can make the health service their health service. If these proposals help that process, I shall be very pleasedif they do not, I shall be less pleased, because those are my tests to measure their success.
	I once saw a campaigner wearing a huge badge that said, XWearing badges is not enough; nor is changing institutions. We have to have the right intentions; we have to listen to the response when it comes, and act on it. We will confront the issue about money at some point, although it will not be in our gift here at Westminster, of course, because we will have given that opportunity away. It is called devolution. Nevertheless, we will have an important view and there need be no worry that it will be properly put.
	I welcome the fact that some of the institutions in the Bill will help make change. They will test one or two of the old boys' clubs current in the bureaucracy surrounding the health service. If we say what standards we require, people will say exactly what they want. Wales is the appropriate place for those institutions to carry out the Government's intentions in practice, given that it was the place that designed and achieved the national health service, as my hon. Friend the Member for Aberavon (Dr. Francis) articulated earlier.

Ian Lucas: This has been a long and interesting debate. Right hon. and hon. Members have been almost unanimous in welcoming the Bill. Part of the reason that the Bill has been so widely welcomed is the procedure that has been followed to bring us to this point. The scrutiny that has taken place has ironed out some of the differences between the various parties and the Government have in many respects already addressed the smaller issues that were raised during the process. However, the Bill is largely uncontroversial and I therefore caution against the inference that the procedure that has been followed for this Bill is the best possible when considering legislation for Wales.
	I want to say, at the outset, that the onset of draft legislationa tremendous innovation by the Governmentgives us a great opportunity to forge a working relationship with the National Assembly for Wales. Within the context of draft legislation, we can begin to deal with the major constitutional challenges brought by the establishment of the Assembly.
	The Government decided that a draft Bill for Wales should first be looked at by the Welsh Affairs Committee. That was a useful experiment, but I am not a member of the Welsh Affairs Committee, and I have an interest in, and experience of, the health field, and I should have liked to contribute to the Bill at an earlier stage than now. The fact that the Welsh Affairs Committee is a territorial Committee is relevant in the context of draft legislation. One of the great benefits of the Select Committee system is that it enables Members to develop specific expertise, which they can bring to bear in consideration of any Bill that relates to the individual topic. The Welsh Affairs Committee does not have the same merits as a departmental Select Committee in that respect.
	My view is that a special Committee should be set up to look at draft legislation of this type. As I have said before, I believe that that Committee should be made up of Members of this House and Members of the National Assembly for Wales. I am pleased that, today, the Chairman of the Welsh Affairs Committee has adopted my suggestion and appears to be following the course that I have set out previously. It is important that we follow that course for two main reasons. First, it would mean that a thread would run from the inception of any policy in the Assembly through to the passing of the Bill in the UK Parliament. Assembly Members would be present at the beginning of the Bill when the ideas were brought forward, and, at the onset of draft legislation, they would become members of a Committee with Members of this House and would work together to improve the Bill.
	At that stage, once the preliminary consideration of the draft legislation had taken place, the Bill would be shifted up to Westminster, and the Committee members from Westminster who had been looking at the Bill could pass on the information, experience and arguments of Assembly Members to this House. That would ensure a rigorous line of scrutiny from inception of ideas through to passing of legislation. That is a sensible framework that at least deserves to be tried. The test will come when we have a contentious piece of legislation. The Select Committee format is very positive, and as a new Member I have been impressed by the way in which Select Committees operate and relationships develop, even with Members from Opposition parties.

Mr. Deputy Speaker: Order. I am not sure that this is the most apt occasion for a constitutional essay. I hope that the hon. Gentleman will come to the Bill in a moment.

Ian Lucas: I am obliged, Mr. Deputy Speaker. I am coming to the Bill now.
	The issue on which I want to focus is the retention of community health councils. My experience of community health councils comes from a different perspective, which has not been mentioned in the debate so far. Before I came to the House, between 1997 and 2001, I was a non-executive director of the Robert Jones and Agnes Hunt hospital at Gobowen. It is an unusual hospital. It is two miles from the border with Wales and provides a great deal of help, expertise and care to people from north Wales, mid-Wales, Shropshire and the surrounding area.
	In my role as a non-executive director, I was also complaints convenor and had much experience of dealing with members of the CHC. It played an extremely valuable role in putting together submissions on behalf of people who would not usually be able to put together submissions themselves. It presented complaints in a NHS procedure that is, in my experience, the most complex one that anyone making a complaint could encounter. The procedure is bedazzling to all those who deal with it, including me as a trained lawyer.

Gareth Thomas: I know that my hon. Friend has an interest in this subject. He has not only been involved in health service management but is a lawyer who has experience of clinical negligence claims. He will recall that I chaired a seminar on clinical negligence in the House. Does he think that there is a role for CHCs and the Wales Centre for Health in trying to bring about a more effective complaints system? Such a complaints system would offer the patient a quicker and more transparent explanation of what had gone on in an adverse incident, as it is termed by doctors. It would also have the ability and power to make small awards and compensation without recourse to the long-winded procedure in the courts.

Ian Lucas: There is, indeed, an essential role for the CHCs. In my role as a member of the board of a hospital that provided health care to people in north Wales, I knew that the submissions and complaints made by patients were a valuable management tool for the hospital. They helped to improve the standard of care that was delivered. One of the major challenges that the NHS faces is to find a system that responds to the concerns and complaints of patients and does so in an environment that does not threaten the providers of the carewhether they are doctors or nurses. The CHCs need to develop a partnership role with hospitals so that information can be presented in a uniform way as far as possible. That information would then be a valuable management tool for the hospital.
	I must confess that another aspect of the Bill causes me concern, and it relates to cross-border care. I represent Wrexham, which is a border town. Health care is supplied to it by the Countess of Chester hospital, Wrexham Maelor hospital and the Robert Jones and Agnes Hunt hospital near Oswestry that I have already mentioned. More specialist care is provided in Liverpool and Manchester. However, the Bill does not appear to be clear on the important question of whether the CHCs in north Wales, which will continue, will have the investigatory powers to examine matters in England. I hope that my hon. Friend the Minister will clarify that point when he winds up. Many of my constituents who see me about health care problems tell me that they have been treated across the border and want to pursue their case just as readily as they could if the hospital were in Wales.

Lembit �pik: My personal experience of Gobowen hospital has always been positive and just as the hon. Gentleman describes. Does he agree that we may want to explore the important matter that he raises in Committee? There will unquestionably be issues on jurisdiction to deal with and it may be the case that the CHC will need to have the authority to act on a non-statutory basis across the border.

Ian Lucas: I agree. The issue has not been raised sufficiently. Most hon. Members who have contributed to the debate do not have the same cross-border services as those of us who work in north-east Wales.

Huw Irranca-Davies: Does my hon. Friend also agree that because the issue is long standing, the Bill gives us the opportunity to address it? One way or another, we have to ensure that we satisfy the requirement for accountability on cross-border issues.

Ian Lucas: My hon. Friend is also correct. We must be conscious of the fact that we are in an era in which health care and the experts are becoming more specialised. It is simply not the case that every district hospital can provide expertise of the highest quality. Although the mantra XWelsh solutions for Welsh problems is appealing, when my constituents come to me for good quality health care, they do not mind whether that is supplied in Chester or Wrexham. What they want is a decent service and a good standard of care.

Nigel Evans: Would not the hon. Gentleman prefer it if the CHCs in his area were in discussions with the sister organisation in Chester, for instance, so that it could investigate the problem? After all, part of the problem is that his Government abolished CHCs in England and we are trying to preserve them for Wales. Does he not have faith in the sister organisations in England?

Ian Lucas: I know from close discussions with health professionals, health consumers and patients in north-east Wales that there are close working relationships of all types between people who work on different sides of the border. Indeed, many health professionals are employed by more than one hospital spending, for example, 50 per cent. of their time in Chester and 50 per cent. in Wrexham. Areas such as north-east Wales recognise that the services must be provided on both sides of the border. The care needs to be of a high quality. I am sure that good relationships will be developed in due course.
	Another aspect that I greatly welcome is the extension of the CHCs' powers on primary care and the inspection of private facilities that offer NHS services. Will that inspection extend to voluntary organisations that provide health care? I have in mind the Nightingale House hospice in Wrexham. It provides an excellent standard of care and would have nothing to fear from an inspection regime. Will CHCs be able to inspect hospices?
	For once I take issue with my hon. Friend the Member for Caerphilly (Mr. David). There are excellent nursing homes in the private sector that provide high-quality care. I have inspected the Pendine Park nursing home in my constituency. It is a high-quality home that provides an excellent service. Private nursing homes have nothing to fear from the system of assessment, but it is good that the CHCs have that additional power.
	I welcome the Bill. The substance is good, but the procedure by which we reached this point could be improved. The Bill is positive for Wales, and although it may need some refinement in Committee, I am sure that it will be a good step in the right direction for my constituents in Wrexham and I am pleased to support it.

Chris Grayling: This has been an interesting and wide-ranging debatesometimes a little too wide-ranging for the Chair. In some ways, however, it has not been as wide-ranging as it might have been because, as some hon. Members have said, this is not quite the Bill that was anticipated, so much of the Government's planned reforms for Wales having already been handled in the National Health Service Reform and Health Care Professions Act 2002.
	The debate began with the Secretary of State making a strong defence of the Bill and of the NHS in Wales. However, he failed to explain why such high levels of spending per head of population have not led to better health outcomes, and he admitted that not all was well with waiting lists. During his speech there was a noteworthy intervention by the hon. Member for Blaenau Gwent (Llew Smith), who basically asked, XWhatever happened to our bonfire of quangos? I got the impression from the Secretary of State's response that he believed that the only problem in the past was that we had the wrong kind of quango.
	My hon. Friend the Member for Ribble Valley (Mr. Evans) made a telling attack on the failures of the current Administration to deliver improvement. He warned that the Bill risked putting too much control into the hands of politicians. He also pointed out that it delivers more change to a service that is already struggling with very considerable change.
	We have had numerous contributions, including many from members of the Select Committee. Those speeches addressed the measure itself but they also strayedas I said, sometimes rather too far for the comfort of the Chairon to wider Welsh health issues ranging from the health benefits of free bus passes to a call for free eye tests, and even, in the case of the hon. Member for Aberavon (Dr. Francis), making a foray into the labour wards.
	The Bill is not directly about the treatment of patients, but it is about the creation of new organisations designed to improve the quality of health care in Wales. The key question that needs to be asked tonight and in Committee is, XWill these changes ultimately make a difference to patients in Wales? That is the criterion by which any change of this kind must be judged.
	Conservative Members do not take issue with the overall nature of the organisations, but we think that important modifications need to be made to the detail of the Government's plans. The Bill concentrates too many powers in the hands of the Assembly and too few in the hands of communities and health care professionals. In Committee, we will want to put forward different ideas about how the organisations should operate. We also question whether the Bill risks creating unnecessary duplication at a time when the NHS in Wales has many other pressing priorities.
	At the heart of the Bill are the community health councils. The Bill marks an astonishing U-turn by Ministers, who are tonight heading in a direction diametrically opposed to the one that they took in the House only a few months ago. We Conservatives have always supported the role of the CHCs in providing a proper link between local communities and the NHS and in monitoring the effectiveness of the service that it provides, and until recently so did the Prime Minister. In 2000, his office wrote to his local CHC, praising its work and that of its counterparts. The letter said:
	XTony would certainly like to add his congratulations to the work the CHCs have done over the last 25 years, and wishes them every success in the future.
	Only two years after that letter, CHCs have been abolished in England.
	We opposed the changes put forward by the Government earlier this year in the same way that we support tonight the retention of CHCs in Wales. Earlier this year, however, the Government told us that we were wrong. Indeed, we were lectured by the Parliamentary Under-Secretary of State for Health, the hon. Member for Salford (Ms Blears), who said on 15 January:
	XWe are all tempted to stick with what we know because it is comfortable and we have seen it in practice, but we must now push forward the boundaries and consider new ways of working to empower the public, too.[Official Report, 15 January 2002; Vol. 378, c. 226.]
	How is it necessary to push forward the boundaries in England and not in Wales? The Secretary of State for Health put it even more strongly, telling the House:
	XNo organisation has a God-given right to exist. Governments do not have a God-given right to exist. Community health councils do not have a God-given right to exist. MPs do not have a God-given right to exist.[Official Report, 10 January 2001; Vol. 360, c. 1089.]
	Have Ministers had a vision on the road to Damascus? Here they are, a matter of months later, telling us that CHCs are the right way forward for Wales. Ten months ago, the Under-Secretary of State for Wales voted against Conservative amendments to the National Health Service Reform and Health Care Professions Bill that would have retained community health councils in England. Tonight, he will vote in favour of community health councils. He cannot have it both wayseither CHCs are a good idea or they are not; they cannot be both.
	We welcome the U-turn and the plan to retain CHCs in Wales. Our concerns about the Bill centre on the provisions that allow the Assembly extensive controls over Welsh CHCs.

Huw Irranca-Davies: Does the hon. Gentleman recognise that he has just paid a magnificent back-handed tribute to the good common sense of Welsh elected representatives? Furthermore, he might like to realise that we now have devolution.

Chris Grayling: If the hon. Gentleman believes so strongly in CHCs, why have he and his colleagues deprived English patients of the right of representation by CHCs?
	To be effective, CHCs must be independentthat telling point was made by my hon. Friend the Member for Leominster (Mr. Wiggin). CHCs must be free to represent the interests of the communities and patients in the areas they cover. They do not exist to be controlled by politicians. The Government should not put as many powers into the hands of the Assembly as they are giving it in the Bill. The Assembly cannot be both provider and monitor of servicesit cannot be both poacher and gamekeeper. During debates on these measures, our Conservative colleagues in the Assembly argued for a strong, independent organisation to co-ordinate the work of CHCs and to remove some of the prescriptive powers that the Bill would give to the Assembly.

Lembit �pik: Surely politics is different. Politicians who do not do a good job will lose their seats. We are talking not about trying to sell a service to the public but about being judged on the outcomes, so the poacher-gamekeeper analogy is not entirely valid.

Chris Grayling: The Conservatives believe that the role of CHCs is to challenge what is happening within the NHS, and that, by definition, means challenging decisions taken by politicians who control the NHS. That is why it is so important that CHCs are a truly independent voice, not subject to undue controls placed on them by central Government.
	We need to ensure that Welsh CHCs are properly independent of political manipulation, which was mentioned by the hon. Member for Cardiff, Central (Mr. Jones). In Committee, we will table amendments to strengthen the role of CHCs and their independence from politicians. In an intervention, the hon. Gentleman called for better auditing of the outputs of the NHS in Wales. Given its poor performance, his words are especially important. They go to the nub of why we must ensure that CHCs have a powerful voice in the communities they seek to represent.
	Any assessment of NHS performance in Wales today does not make happy reading. The Secretary of State is right to say that spending per head in Wales has been much higher than the national average in recent years, and the Wanless report highlighted the fact that Wales has more doctors per head of population than England, as well as shorter GP lists and higher prescribing rates. Despite that, by any objective judgment, the NHS in Wales is not delivering for patients what it should be delivering. That must be a priority for CHCs as they examine what is happening within the service. That is why it is important that the Bill gives them the freedom to do so.
	In reality, things are getting worse. In the past three years, waiting lists have been rising by 1,000 people a month. In the past five years, the number of people waiting more than 12 months for in-patient treatment has increased by 82 per cent. The number of people waiting more than 12 months for out-patient treatment has increased from just 378 five years ago to more than 36,000 today. In 1997, no one waited more than 18 months for such treatment; today, more than 16,000 people are waiting. That is nothing short of a scandal. Having heard the comments of the hon. Member for Brecon and Radnorshire (Mr. Williams), I say to him that those are real figures about real people waiting for real treatments, and those people deserve better. I would tell the hon. Member for Montgomeryshire (Lembit pik) that no hon. Member should feel proud of that situation, still less one who represents a party that is part of the Administration in Cardiff. We want CHCs to address those issues. As the hon. Member for Caernarfon (Hywel Williams) pointed out, they need to serve as metaphorical high explosive to make sure that there is real change for the benefit of patients.

Lembit �pik: I am sorry to interrupt the hon. Gentleman a second time, but I hope he agrees with other hon. Members that we are lucky to have a national health service at all. For all the difficulties that people experience in the NHS, surely he is not suggesting that we are not privileged in our standard of living and health provision.

Chris Grayling: I find it distressing that at a time when more and more money is being spent on the service it is getting worse. None of us should be proud of that.
	Turning to the implementation of the proposals, we are concerned about the ability of the NHS in Wales to tackle a further round of organisational change when clinical targets are not being met and organisational plans appear to be in chaos, despite the fact that the NHS has been hiring administrators three times faster than doctors. In Committee, we must ensure that we do not add to the burdens that NHS management are already facing. My hon. Friend the Member for Ribble Valley (Mr. Evans) spoke about the problems caused by the latest set of Government reforms in Wales, the establishment of 22 health boards and the document leaked to the BBC a month ago questioning whether they would work at all. We are told that the cost of the changeover and the future operation of the system is still unknown; that the changeover may not happen on time; that the NHS in Wales cannot find enough applicants to fill key posts in organisations; and that there are real fears that the system for funding health care in Wales after April will be launched in chaos. All that will make the implementation of the Bill more difficult, so the changes outlined and discussed tonight must be seen against the background of a system that is not working for patients and the dedicated staff who work long hours. That is the true priority for Welsh health Ministers.
	Turning briefly to other bodies covered by the Bill, we are concerned about possible duplication between the new Welsh bodies set up by the Bill and existing organisations elsewhere in the United Kingdom. For example, we are uncertain about the provision for the Wales Centre for Health to commission research into health matters in its own right. It would be foolish in the extreme to have a service commissioning research that is duplicated elsewhere in the United Kingdom.

John Smith: Will the hon. Gentleman please recognise that some health issues are of greater concern in Wales than in other parts of the country? One group in Wales that will welcome the creation of the centre consists of the victims and families of victims of flight-related deep vein thrombosis. A higher proportion of people die and develop serious injury from that disease in Wales than anywhere else in the United Kingdom.

Chris Grayling: The hon. Gentleman should realise that that condition affects people throughout the UK, which is precisely why we should ensure that resources in different parts of Britain are pooled for the maximum benefit of patients.
	We are also concerned about possible duplication between Health Professions Wales and organisations that the Government have established for the UK as a whole. Ministers need to ensure that those organisations work together effectively. In particular, they should not create different training and registration criteria for our health care professionals, thus making it difficult for them to work in one part of the UK after working in another. I hope very much that Ministers will exercise great caution on that score.
	The Bill is not controversial in itself, but it comes at a time when the NHS in Wales is in turmoil. It is failing to meet its clinical goals and, far from getting better, it is getting worse. It is tangled up in a major reform process that is also in turmoil, and huge amounts of work remain to be done if the transition next April is to occur without causing real problems to the people who work in the service. Welcome as some of the Bill's provisions are, welcome as the retention of CHCs is, the Bill will not help to tackle those problems. Too much of its detail leaves power in the hands of politicians, not communities and professionals. Conservative Members have argued for years that the reason why the NHS is not delivering the first-rate health care that patients deserve is that it is too centralised and prescriptive. Too many of the provisions before the House fall into the same trap and we will work to change them as the Bill continues its passage.
	The Government simply do not seem to understand that that centralised approach will not deliver the improvements that people want and need. Wales is the living example of what is wrong with their health policies. Spending in Wales is already much higher than the national average, but the NHS in Wales is heading backwards, and until the Government take on board the real lessons from this situation, nothing that we discuss in the House will make the difference that people in Wales and elsewhere in the United Kingdom are hoping for.

Don Touhig: We have had a very good and constructive debate on the Bill.
	In summary, the Bill has three key elements: it provides a new role for reformed community health councils as the main vehicle for giving patients a greater say; it establishes the Wales Centre for Health to provide independent training, advice and research in health care; and it establishes Health Professions Wales to provide education and training to the health care professions.
	We have heard in the debate that the pre-legislative scrutiny process in which we have been involved has been very successful. Publication of the Bill in draft, including on our Wales Office website, has allowed thorough consideration in all policy areas. Here in the Commons, the Bill was considered by the Select Committee on Welsh Affairs and debated in the Welsh Grand Committee. In another place, peers met the Assembly's Minister for Health and Social Services, Jane Hutt, and me, and in the Assembly, the Bill was discussed in the Health and Social Services Committee and in plenary session. The extensive public consultation on the draft Bill has ensured that the most important peoplethe people who will be affected by the legislation; the people of Waleshave had an opportunity to contribute.
	Eighty-seven groups and organisations were invited to comment on the Bill, which was extensively scrutinised. We also published the Bill on the Wales Office website, which produced 15 responses, including an e-mail from a Mr. Liu Lieu, who runs a company in China and offered to sell us an excellent forging hammer. I think that something was lost in the translation.
	In total, that process produced 45 recommendations for changes to the draft Bill. It says much for the effort that was put into the original drafting that the Bill received widespread support from stakeholders and that none of the pre-legislative scrutiny revealed any major concerns about the principles of what was proposed. The amendments made to the Bill following the pre-legislative scrutiny were all minor and of a technical nature.
	The Bill has been in preparation for a long time in the sense that the proposals for reforming and retaining community health councils were first mooted by my hon. Friend the Member for Bridgend (Mr. Griffiths) in his first week after being appointed Minister with responsibility for health in Wales following the 1997 election of a Labour Government. Our reform agenda has been to reinvigorate and change community health councils in Wales. That has been universally accepted throughout the country, and the Welsh Affairs Committee helpfully contributed to that debate and expressed its support.
	What the Bill proposes for community health councils in Wales is an essential element for the Assembly's wider strategy of involving the public in health service planning and delivery and listening to their views and concerns. The independence of community health councils in Wales is rightly cherished and we will ensure through the mechanisms in the Bill that they are independent and can deliver the services required by their communities.
	The establishment of the Wales Centre for Health originated in the XBetter HealthBetter Wales document produced by the Wales Office in 1998. The foundations for creating the Wales Centre for Health were laid before devolution. The Government are now carrying them forward in partnership with the Assembly. In addition, the creation of the body that will oversee training and so on, Health Professions Wales, has been well-received and widely welcomed and will make an important contribution.
	The Government were unable to take on board some aspects of the recommendations. As hon. Members have referred to a couple of those issues, I think that I should also mention them. The seventh recommendation of the Welsh Affairs Committee was that the Bill be amended to allow community health council members a statutory right to time off work for public duties. Other respondents made the same comment. While the Government strongly sympathise and understand and fully support people's opportunity to serve on community health councils, after having reflected, we did not consider that the Bill was the appropriate measure or vehicle in that regard. The Employment Rights Act 1996 contains a list of bodies whose membership attracts statutory time off. It could be amended by order and we will give further consideration to approaching the relevant Secretary of State with that in mind.
	A ban on smoking in public places was a further suggestion from the Welsh Affairs Committee that we could not accept. After considering the proposal, we decided that such a measure was beyond the scope of the Bill and would entail creating a new public offence. A health Bill is not the proper vehicle for that.
	I want to comment briefly on the remarks made by as many hon. Members as possible. The hon. Member for Ribble Valley (Mr. Evans), who led for the official Opposition, welcomed the draft Bill but provided his usual litany of all the woes that he perceives in the NHS in Wales. He quoted two statements:
	XYou have 24 hours to save the national health service,
	and
	XThe National Health Service is safe in our hands.
	I accept ownership of the first on behalf of my party. We said that to the people of Britain, and they elected a Labour Government. However, the second statement was originally made by Baroness Thatcher when she was Prime Minister. She said that the NHS was safe in Tory hands. My right hon. Friend the Member for Oldham, West and Royton (Mr. Meacher) responded by saying that that was as encouraging as putting King Herod on the board of Mothercare.
	The hon. Gentleman also referred to the National Assembly's powers to make regulations. They will be exercised in the way prescribed by Assembly Standing Orders. Public consultation will take place before any regulations are made and I shall be happy to convey the Assembly's intention on each of the orders when we discuss the Bill in Committee, if that is helpful.
	The hon. Gentleman spoke with some passion about nurse training. The Conservative Government cut the number of nurses and midwives in training by 25 per cent. in the mid-1990s and I am therefore not surprised that he is passionate about the matter. Those cuts led directly to the shortage of nurses that we inherited.
	I thank my hon. Friend the Member for Clwyd, South (Mr. Jones) for all the work that he and Welsh Affairs Committee undertook on pre-legislative scrutiny. He welcomed the Bill as a progressive measure and spoke about the opportunities that it would provide through its CHC provisions to respond to patients' voices in the health service.
	The hon. Member for Montgomeryshire (Lembit pik) said that the pre-legislative consultation had been successful. I thank him for correcting some of the points in the research paper that was produced in the House on the costs of the proposed reorganisation. He was worried about co-terminosity with regard to CHCs. There is provision for CHCs to work in federations. However, I understand that that would not work in his large constituency. The Bill and the Assembly's regulation-making powers have sufficient flexibility to deal with those points.
	My hon. Friend the Member for Ogmore (Huw Irranca-Davies) asked several questions to which I shall try to respond. He asked whether Health Professions Wales would have an input into the standards on overseas recruitment to ease assimilation. It may adopt functions from the Nursing and Midwifery Council only with the agreement of that body. That is a matter for Health Professions Wales when it is established.
	My hon. Friend also asked about extending the role of CHCs to examining health provision in prisons. The National Health Service Reform and Health Care Professions Act 2002 requires the Prison Service and prescribed NHS bodies to co-operate with the view of improving health care in prisons. We do not believe that CHCs have a role in that and the Bill does not make such provision.
	My hon. Friend and several other hon. Members raised matters about CHCs' cross-border operation. Powers for CHCs, including those to require information and undertake inspections, will be the same for CHCs in Wales as those that we gave patient forums in England in the National Health Service Reform and Health Care Professions Act 2002. The Bill's language will mirror that of the 2002 Act. That reciprocal arrangement is sensible and will work beneficially for all of us.
	The hon. Member for Leominster (Mr. Wiggin) said that he was disappointed that the Government had not responded more positively to the Welsh Affairs Committee report. It was debated thoroughly in the Welsh Grand Committee. We carefully considered the comments of the Welsh Affairs Committee and adopted several although not all their proposals. There was widespread consultation and the hon. Gentleman and anyone else who felt strongly about our responses could have contributed at the pre-legislative scrutiny stage.
	My hon. Friend the Member for Cardiff, Central (Mr. Jones), a former Wales Office Minister with responsibility for health, made important points about choice, which underpins the aims of our NHS reforms. I share my hon. Friend's views about the independence of CHCs. Any monitoring, appraisal and inspection of the health service must be open and transparent and must be seen to be fully transparent.
	My hon. Friend referred to delayed discharges and bed blocking. I shall leave that to my colleagues who are dealing with the Community Care (Delayed Discharges etc.) Bill tomorrow. In response to the question whether the Bill could be amended to enable community health councils to investigate delayed discharges, I can tell my hon. Friend that I believe that the powers in the Bill are sufficient. Under paragraph 1(a) of schedule 7A, it is the duty of a CHC
	Xto represent the interests in the health service of the public in its district.
	The powers that we will confer on CHCs will cover the point that my hon. Friend raised.
	The hon. Member for Caernarfon (Hywel Williams) said that patient power must be enabling. I agree. The thrust of our CHC reforms is intended to enable patients to exercise more power and influence on the health service. We must make sure that that works.
	My hon. Friend the Member for Cardiff, North (Julie Morgan) spoke about the developing roles of community health councils and put forward some interesting perspectives. I do not know whether she will serve on the Committee, but we can explore there the perspectives that she outlined in her comments this evening.
	The hon. Member for Brecon and Radnorshire (Mr. Williams) gave his wholehearted support to the Bill. I welcome that. The fact that he was able to do so stems from the fact that we had wideranging pre-legislative scrutiny, which enabled members of all political parties or of none to make a contribution to the way in which the reform should be structured. That is reflected in the Bill.
	My hon. Friend the Member for Gower (Mr. Caton) believed that the Welsh Affairs Committee did a good job on the pre-legislative scrutiny, and I agree. The Committee did an excellent job, which is a model for future pre-legislative scrutiny. He welcomed the partnership approach between the Government and the National Assembly for Wales. I have had the closest working partnership with my colleague Jane Hutt, the Assembly Minister for Health and Social Services. We have had the closest collaboration between my officials and hers, which is reflected in the strong support that we received throughout the pre-legislative scrutiny. This is how we are trying to take the agenda forward in Wales: the Government working in partnership with the Labour-led Assemblythe hon. Member for Montgomeryshire might care to note thatthe Labour-led Assembly. That is proving beneficial for the people of Wales.
	My hon. Friend the Member for Aberavon (Dr. Francis) also welcomed the reforms to CHCs and gave some interesting and important historical perspectives on how we had developed a democratic and a socialist health service as a result of the work of Aneurin Bevan.

Roger Williams: The hon. Member for Aberavon (Dr. Francis) waxed lyrical about the support that the NHS was given by socialists, but does the Minister agree that it was conceived by a LiberalBeveridge?

Don Touhig: Nye Bevan was certainly no Liberal, and he was the architect of the national health service. We share that honour with no one.
	My hon. Friend the Member for Caerphilly (Mr. David) said that although the Bill was short, it was important and it would make a difference. I certainly agree. My hon. Friend the Member for Merthyr Tydfil and Rhymney (Mr. Havard) said CHCs in his area did good work and he wished to see their role develop, especially the advocacy role. We will see that develop, following the introduction of the Bill. My hon. Friend the Member for Wrexham (Ian Lucas) welcomed the pre-legislative scrutiny procedure and wondered whether it could be improved. I am sure that we will return to the matter later in our discussions. CHCs will have the power to inspect hospices, where they are delivering primary care. That is an important point to make.
	I thank all hon. Members who have taken part in the debate. I thank those who took part in the pre-legislative scrutiny, those in the Welsh Affairs Committee, the Welsh Grand Committee and colleagues in the National Assembly, who made an important contribution to our discussions in formulating the policy. As a result of the pre-legislative scrutiny, we have a better Bill now than we would otherwise have had, and that is a lesson for all of us. I remember a time when I had a private Member's Bill soon after coming to the House. If we had had pre-legislative scrutiny at that time, that piece of legislation might well have been improved.
	The Bill builds on the strategic framework put in place by the NHS Reform and Health Care Professions Act 2002, which was passed in the last Session. It gives patients in Wales a stronger role and a voice in the improvement, development and running of the health service in Wales, to which we are all committed, and changes the emphasis from treating disease to improving health in Wales. It supports the Welsh Assembly's drive to improve the health and well-being of people of Wales and delivers key elements of the Assembly's 10-year plan for the health service in Wales.
	This is an excellent example of the partnership that exists between the Government and the National Assembly. We have already achieved a great deal by working together, and I commend the Bill to the House and ask hon. Members to support its being given a Second Reading.
	Question put and agreed to.
	Bill read a Second time.

HEALTH (WALES) BILL (PROGRAMME)

Motion made, and Question put forthwith, pursuant to Orders [28 June 2001 and 29 October 2002],
	That the following provisions shall apply to the Health (Wales) Bill:
	Committal
	1. The Bill shall be committed to a Standing Committee.
	2. The proviso in paragraph (2)(ii) of Standing Order No. 86 (Nomination of Standing Committees) shall not apply to the Bill.
	Proceedings in Standing Committee
	3. Proceedings in the Standing Committee shall (so far as not previously concluded) be brought to a conclusion on Thursday 12th December.
	4. The Standing Committee shall have leave to sit twice on the first day on which it meets.
	Consideration and Third Reading
	5. Proceedings on consideration shall (so far as not previously concluded) be brought to a conclusion one hour before the moment of interruption on the day on which those proceedings are commenced.
	6. Proceedings on Third Reading shall (so far as not previously concluded) be brought to a conclusion at the moment of interruption on the day on which proceedings on consideration are commenced.
	7. Sessional Order B (programming committees) made on 28th June 2001 shall not apply to proceedings on consideration and Third Reading.
	Other proceedings
	8. Any other proceedings on the Bill (including any proceedings on consideration of Lords amendments or any further messages from the Lords) may be programmed.[Mr. Jim Murphy.]
	The House divided: Ayes 240, Noes 72.

Question accordingly agreed to.

Julian Lewis: On a point of order, Mr. Speaker. Did you notice, during the vote, a senior Cabinet Minister walking the length of the Chamber, presumably on her way to vote, clutching a mobile phone to her ear? Is that appropriate behaviour from any hon. Member, let alone a senior Cabinet Minister?

Desmond Swayne: Further to that point of order, Mr. Speaker. You will recall, because I wrote to you a fortnight ago, that on Friday a couple of weeks ago an hon. Member entered the Chamber, sat just below the Gangway and sought to be called wearing a pair of jeans. Surely there must be a limit to modernisation.

Mr. Speaker: That matter did not arise today. The hon. Gentleman wrote to me, and when hon. Members write to me I deal with their complaints. So I have dealt with that matter.
	I say to the hon. Member for New Forest, East (Dr. Lewis) that no hon. Member should come into the Chamber with their mobile phone. All mobile phones should be switched off before they come into the Chamber and no one should be in conversation on a mobile phone. I certainly hope that note is taken of the hon. Gentleman's complaint.

HEALTH (WALES) BILL [MONEY]

Queen's recommendation having been signified
	Motion made, and Question put forthwith, pursuant to Standing Order No. 52(1)(a) (Money resolutions and ways and means resolutions in connection with Bills),
	That, for the purposes of any Act resulting from the Health (Wales) Bill, it is expedient to authorise the payment out of money provided by Parliament of any increase attributable to the Act in the sums payable by virtue of any other Act out of money so provided.[Derek Twigg.]
	Question agreed to.

DELEGATED LEGISLATION

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6)(Standing Committees on Delegated Legislation),

Contracting Out

That the draft Contracting Out (Functions in Relation to Applications for Patents) Order 2002, which was laid before this House on 5th November, in the last Session of Parliament, be approved.[Derek Twigg.]
	Question agreed to.
	Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6)(Standing Committees on Delegated Legislation),

Legal Services

That the draft Access to Justice Act 1999 (Solicitors' Practising Certificates) Order 2002, which was laid before this House on 13th November, be approved.[Derek Twigg.]
	Question agreed to.
	Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6)(Standing Committees on Delegated Legislation),

Health Care and Associated Professions

That the draft Medical Act 1983 (Amendment) Order 2002, which was laid before this House on 14th November, be approved.[Derek Twigg.]
	Question agreed to.
	Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6)(Standing Committees on Delegated Legislation),

Northern Ireland

That the draft Local Government (Miscellaneous Provisions) (Northern Ireland) Order 2002, which was laid before this House on 15th November, be approved.[Derek Twigg.]
	Question agreed to.

BUSINESS OF THE HOUSE

Ordered,
	That, at the sitting on Monday 2nd December,
	(1) proceedings on the Motion in the name of the Reverend Ian Paisley shall lapse, if not previously concluded, at Seven o'clock or three hours after they have been entered upon, whichever is the later, and paragraph (2) of Standing Order No. 31 (Questions on amendments) shall apply to them as if the day were an Opposition Day; and
	(2) the Speaker shall put the Questions necessary to dispose of proceedings on the Motion in the name of the Prime Minister relating to the Convention on the Future of Europe not later than three hours after they have been entered upon, and the proceedings may continue after the moment of interruption.[Derek Twigg.]

PETITIONS
	  
	Israel

Fiona Mactaggart: It is a privilege to present to the House a petition signed by more than 700 residents of Slough. In the letter that accompanies the petition, the organiser, Mr. Baig, urges us to change what he calls
	Xthe immoral and inappropriate stance the Government has taken by not coming out clearly to condemn the continuous Israeli occupation and its failure to support the oppressed people of Palestine with any practical means beyond futile rhetoric.
	The petition states:
	The petition of residents of Slough and others
	Declares that Palestinians are victims of brutalities committed by Israeli security forces and that the British Government is a silent bystander in the face of such war crimes.
	The Petitioners therefore request that the House of Commons urge the Government to take steps to prevent war crimes against innocent and defenceless Palestinians.
	To lie upon the Table.

Consumers for Health Choice

10.17 pm

Ian Stewart: This petition is presented by Mr. Michael Grace of the Village Health Food store in Eccles and his customers. I have been a customer of that store for many years.
	The petition states:
	The petition ofConsumers for Health Choice and its supporters,
	Declares thatconsumers in the United Kingdom have for many years maintained good health by choosing to take safe vitamin and mineral supplements and herbal remedies; and fears that the European Food Supplements Directive and the proposed European Directive on Traditional Herbal Medicinal Products would severely restrict the number and range of such products on general retail sale in the future.
	The petitioners therefore request that the House of Commonsrequires that the Secretary of State for Health does all in his power to protect the rights of UK consumers by ensuring that such European legislation does not unnecessarily and unacceptably restrict the availability of natural health products.
	To lie upon the table.
	10.18 pm

David Cameron: I have great pleasure in presenting two petitions. The first follows on exactly from the previous one. It has been given to me by Mr. Brigh of the Bean Bag health store in Witney.
	The petition has 1,100 signatures. The petition states:
	Consumers in the United Kingdom have for many years maintained good health by choosing to take safe vitamin and mineral supplements and herbal remedies; and fears that the European Food Supplements Directive and the proposed European Directive on Traditional Herbal Medicinal Products would severely restrict the number and range of such products . . . in the future.
	The petitioners therefore request that the House of Commons requires the Secretary of State for Health does all in his power to protect the rights of UK consumers by ensuring that such European legislation does not unnecessarily and unacceptably restrict the availability of natural health products.
	To lie upon the Table.

Cotswold Railway

David Cameron: The second petition that I have to present was put together by Frances Short on behalf of residents of west Oxfordshire and it calls for improvements to the Cotswold railway line, a subject close to my heart.
	The petition states:
	To the House of Commons:
	The petition of residents of West Oxfordshire declares that an infrastructure upgrade is required to reduce delays and produce and hourly service on the Cotswold Railway line.
	The petitioners therefore request that the House of Commons requires the Strategic Rail Authority, the train operating companies and the local councils to fund an infrastructure upgrade on the Cotswold line.
	And the petitioners remain, etc.
	To lie upon the Table.

Consumers for Health Choice

Paul Tyler: The petition that I have the pleasure to present is on behalf of 320 constituents in and around the comparatively small town of Bude. It is a relatively small community, and that is why the number is very significant.
	The petition states:
	To the House of Commons
	The Petition of Consumers for Health Choice and its supporters declares that consumers in the United Kingdom have for many years maintained good health by choosing to take safe vitamin and mineral supplements and herbal remedies; and fears that the European Food Supplements Directive and the proposed European Directive on Traditional Herbal Medicinal Products would severely restrict the number and range of such products on general sale in the future.
	The petitioners therefore request that the House of Commons requires that the Secretary of State for Health does all in his power to protect the rights of UK consumers by ensuring that such European legislation does not unnecessarily and unacceptably restrict the availability of natural health products.
	And the petitioners remain, etc.
	To lie upon the Table.

PRE-SCHOOLS

Motion made, and Question proposed, That this House do now adjourn.[Derek Twigg.]

David Cameron: I am delighted to have this opportunity to raise an issue of growing concern in my constituency, and I expect in the constituencies of many other hon. Members.
	I was slightly surprised to be told that the Minister responding to the debate on behalf of the Government would be the Under-Secretary of State for Work and Pensions, the hon. Member for Liverpool, Garston (Maria Eagle). I mean no disrespect to her, as I know that she is diligent and effectiveand I am looking forward to hearing her response. However, I am raising the problem of the huge bureaucratic burdens faced by pre-schools, many of which are imposed by the Department for Education and Skills. How can a Minister who does not sit in that Department really help to put that right?
	I am talking about children under five, and some of them are as young as two. Even in this Prime Minister's Britain, none of them works and certainly none of them has a pension. There are five Education Ministers in the House of Commons. One of them, the Minister for School Standards, the hon. Member for South Shields (Mr. Miliband), is meant to have a brain the size of a football pitch. Surely he could dedicate just one part of it to pre-schools. However, although I look forward to the answer, I suspect that it will be that this is Xpartnership working between Departments or even, heaven help us, Xjoined-up Government. If it is, I am not sure yet that I am in favour of it.
	Pre-schools and nurseries in my west Oxfordshire constituency provide a magnificent service for children, parents and the wider community. The Government often talk about the need for diversity and choice. This is the one area in education where we already have it. There are, as it were, a thousand points of lightsome provided by the state, some are private and some voluntary, and many are collaborations between parents and supervisors.
	As Sue Harrison, of the fabulously named Blackditch Bunnies pre-school in Stanton Harcourt, explained:
	XThe culture of pre-schools is rooted in parental involvement and community spirit, not central control.
	I have been hugely impressed by what I have seen in Witney, North Leigh and elsewhere in my constituencydedicated staff, contented parents and children getting a first-class foundation to their education.
	So why the need for this short debate? I want to raise two important concerns. First, it is quite clear that the pre-school sector is suffering from over-regulation. Some of the best providers are in danger of being strangled by the red tape. Angela Buckingham of North Leigh nursery told me that she comes close to
	Xspending more time with the paper than with the children.
	Linda Trigg of Cherubs in the Wychwoods says that she is too often
	Xtaken away from childcare because I am filling in the forms.
	Sue Moore, from the Farm House nursery in Witney, told me that eight and half years ago, when she set up her nursery, she spent two hours a week on paperwork. Now it is every day, and sometimes all day. As she put it:
	XThey want you to justify every time you sneeze.
	There are a number of specific areas that are causing this problem. Ofsted inspections have replaced social service inspections. They are much more paper based and they take place, in most cases, every year. Primary schools, by contrast, are not inspected so frequently. The response can take months. One pre-school inspected this January has still not received a written response.

Richard Bacon: I wonder whether it will surprise my hon. Friend to learn what happened to my constituent Anne Beckwith, proprietor of the Discovery nursery in Diss, when she was trying to set up the nursery. Several months after she had completed all the paperwork that Ofsted had asked her to complete, several months after she had answered all the questions and, indeed, several months after being told by Ofsted that she had fulfilled all its requirements, she still could not get the go-ahead. Will my hon. Friend join me in urging the Government to look seriously at Ofsted's procedures, which are clearly too bureaucratic?

David Cameron: I am delighted to hear my hon. Friend say that, because it accords with the thrust of what I am saying. It is all taking too long, the burden is too heavy, and as a result we are in danger of losing some very good pre-school facilities.
	Pre-schools have to draw up dozens of policies and procedures. Although some may have only 20 or so children, they are required to haveat the last count20 policies and four procedures, including policies on record keeping, equal opportunities, behaviour management and much else.
	Another subject that arises time and again in conversation with supervisors and staff at pre-schools is child profiles. I know that they are necessary, but they currently run to 16 pages per child, and some pre-schools do not find them particularly useful. The pre-school in Stanton Harcourt that I mentioned runs its own system alongside the official one. Every supervisor to whom I have spoken agrees that all the profiles could be slimmed down without child safety or protection being affected. Of course pre-schools must be equal opportunities employers, and of course they must have regard to such things as safety, but would not a single brief statement outlining the position be sufficient, rather than a myriad? I ask the Minister to tell the Department to consider its own role in creating much of all that paper.
	There is also a degree of doubling up. Much of the form filling is so that pre-schools can become accredited. Many of the smaller pre-schools want that status because they do not want to be seen as second class; but they ask whether, if they are inspected by Ofsted, that is not enough. I would be grateful if the Minister could look at that specifically.
	Sue Harrison wrote a very good letter to The Independent. I do not always read The Independent, so I do not know whether it was published, but this is what she said:
	XThe new accreditation process has just been one huge paper chase to prove ourselves in print. And we have to endure annual inspections when schools only have one every five years. My committee, all of whom are unpaid and are busy working mums, can't cope with it all. The staff are the only people trained to deal with it but I am paid 3,500 a year to work 12 hours a week, not the 24 which I am working at the moment to keep all those forms filled in . . . Just how has this paper mountain improved the children's learning and well being? I can't think of one instance. Our Ofsted health and safety check was a pale shadow of the disbanded Social Services one. The inspector seemed only interested in the contents of our bulging documents cupboard.
	The supervisors to whom I spoke singled out Ofsted for its habit of using four pages when just one would do. Adrienne Willsdon, the supervisor of Kiddiwinks nursery in Charlbury, said that the registration forms from Ofsted were like booklets, when in fact the name, address, contact details and basic information about the child were all that was really required. The paperwork is not just a burden on staff; it has a knock-on effect on funding and on governing bodies or parents' committees.
	Many pre-schools have no funds for a computer, but how can they be expected to draw up policies, operational plans and the like without one? What happens is that that is done by the supervisor or the committee secretary on his or her own computer at home. If, by some unhappy chance, they leave, much of the information may be lost for good. All that is deterring parents from taking part. One supervisor told me:
	XThe nature of meetings has totally changed. It used to be discussing the rota for the cake stall and whether the hall needed painting, now it is composing policies and forms for which the committee don't see the need.
	The types of paperwork, the forms and the bureaucracy keep changing. The principal teacher of St Hugh of Lincoln nursery school in Curbridge told me:
	XWe fill in the forms, get it all organised . . . and then we have to start all over again.
	The second issue I want to raise is the concern that has been expressed about a proposal that all four-year-olds should go to primary school at a single point of entry. Although the proposal comes from the Oxfordshire local education authority, I understand that it is in line with Government thinking on the foundation stage. The LEA, which has, as ever, been helpful in answering my questions, listed a number of advantages, including the belief that the approach would
	Xgive greater parity of entitlement to all children in the reception year.
	Having listened to the views of many pre-schools, I fear that it could have harmful effects, particularly for provision in my very rural constituency.
	Many of the pre-schools in west Oxfordshire are small. Without the four-year-olds, the pre-schools in some villages may not survive. If that happens, valuable provision for children of two and a half and three would be lost altogether. One pre-school representative was quite frank, saying that if four-year-olds were absorbed into the school, the loss of funding would kill the pre-school without any doubt. Another pointed out that had the policy been in place last year, 20 out of the 30 children would have left in one go, threatening the viability of the pre-school. The Farm House nursery in Witney said that it might lose half of its 28 children. It said that there simply are not enough children of two and a half and three to go round. Pre-schools and nurseries could close. That could have knock-on effects on other provision in our villages.
	A letter from the Finstock village hall committee makes the point about the Woodpecker pre-school, which shares its facilities:
	XInsufficient consideration has been given to the viability of pre-school groups and the income of village halls, once children are admitted to the school from the age of four.
	I accept that pre-schools are not unanimous about this. Some that I have spoken to, particularly in one or two of the larger villages, believe that they will be able to cope with the change. There is also the question of whether the smaller village primary schools will be able to manage with the change once it has taken place.
	As a briefing note sent to me by David Smith, the private sector representative on Oxfordshire's early years development and child care partnership puts it, these schools
	Xare unlikely to be able to make specific provision for younger four year olds either due to the limitations of their premises or because the number of children would not justify it. If younger four year olds are admitted to such schools they are likely to be taught in a mixed age reception class totally unsuited to their needs.
	He concludes that
	Xchildren in rural areas will be further disadvantaged and admission to quality provision will become a lottery.
	The LEA is clear that
	Xa change in admissions policy would create greater choice for parents, and create capacity for children to have their full entitlement in communities where there is currently insufficient provision.
	I fear that in rural areas the exact opposite might happen and that there will be less choice and less capacity. The LEA says that such a change will
	Xend the long standing problem of Oxfordshire's primary admission arrangements being out of line with its geographical neighbours.
	Arguments in favour of tidiness are never the strongest.
	I know that it will be argued that parents have a choice. Yes, they dono child has to go to school before the age of five. However, in the case of popular village schools, parents will always be nervous that if they do not take what is on offer when their child is four, they will miss the boat altogether. That point was made by one of the governors of the ACE centre at Chipping Norton during the public consultation.
	I urge caution in this area and look forward to what the Minister has to say about the Government's view on the difficult issue of the age at which it is right for children to go to school. The proposal for the single point of entry for four-year-olds opens up the debate on what sort of provision is right for children. I tread carefully hereI am no expert. I have just the one child, and he is only seven months old. However, the points that have been made to me about whether the quality of provision in primary schools will be as good as what is on offer in dedicated pre-schools are worth making.
	Sue Gibson from the Daffodil nursery in Long Hanborough, among others, expressed some concerns. The first is over staffing levels. In pre-schools, the supervisor-to-child ratio tends to be 8:1; in primary schools it is more like 13:1, with classes of 26 run by a teacher with a learning support assistant.
	The second concern is over content. Pre-schools are experts in learning through play. Of course, primary schools that do not have early years provision will be able to develop it. However, there is a danger of reinventing the wheel orto mix my metaphors and find a more appropriate onethrowing the baby out with the bath water.
	The third concern is whether primary schools can cope with all the needs of four-year-olds. As many supervisors have told me, some four-year-olds are ready for school, while others still need nurturing more than teaching. Maggie McClay, from St. Peter's nursery in Filkins in my constituency, made this point with real concern. In small schools, will they have to share classes with older children? How will that work? Will children be moved too quickly into years one, two and three?
	Another need that most pre-schools and nurseries can provide, but not all primary schools do, is access to outside space. A meeting was held in Witney on 8 October by the LEA to consult about this. I have a copy of the minutes. One pre-school supervisor who was there told me that, interestingly, none of the primary school representatives from west Oxfordshire who attended the meeting welcomed the change, and the minutes seem to bear that out. I know that this is a difficult issue and the LEA is still thinking about it. From what I have heardand I have spoken to as many pre-schools and nurseries as possible in the past two daysthe case for change is still to be made.
	I would like to end with one further plea. Although pre-schools and nurseries do a wonderful job, as I hope I have demonstrated, they are often short of money for buildings. The LEA has told me that Oxfordshire received 220,000, this year and next, to increase capacity for the whole county. That is only likely to be enough for one project in each area. Clearly, if we are to embark on the huge change of providing a single point of access for all four-year-olds, there will be an enormous need for new facilities. That is why I say that it may be better not to change.
	Many pre-schools still have to move heaven and earth to raise funds. One project with which I have been helping, the Little Oak pre-school in Witney, has a temporary classroom that is rotting away. We have had no help from anybody, but we have managed to find a construction company, Persimmon, which has given us another second-hand building. I thank it for its generosity; it is great that a company is doing something for a community like that.
	The building is just the start, however. It must be transported, made ready and kitted out. The parents and teachers working on this project have shown incredible dedication. Their reward, and the reward of all who work in this vital sector, should be congratulation and support from both central Government and the LEA. I fear that, at present, those involved in pre-schools are instead suffering from over-regulation and change that may not only be unnecessary but damaging.
	I want to end by quoting again from Sue Harrison's letter about her experience in the Blackditch Bunnies pre-school in Stanton Harcourt:
	XMany fellow supervisors have left the profession to work at something better paid (like shelf stacking) and less hard work . . . and who in their right mind would volunteer to be on a committee now? Soon rural pre-schools will implode and leave millions of young children and their mums with nowhere to play and no one to talk to.
	I beg the Minister to recognise that when we have a sector that demonstrates such diversity, such inventiveness and such a high standard of care, we should do what we can to nurture it rather than damage it.

Maria Eagle: First, I want to congratulate the hon. Member for Witney (Mr. Cameron) on securing this debate on the important issue, as his speech demonstrated, of how we provide best for our young children before they have to attend school.
	The hon. Gentleman started his remarks with a gentle suggestion that I might not be the appropriate Minister to deal with these issues. I want to start by assuring him that he is not being short-changed by having me answering his debate. I am not doing any of my colleagues from the Department for Education and Skills a favour of any kind. I am the Minister in the House of Commons who deals with sure start, early years and child care. That recent change was announced at the time of the spending review, along with many other announcements, so I do not criticise him for not spotting it.
	The hon. Gentleman may be aware of the review across Government into this subject, which took a year, the results of which were published on 6 November. He may have seen those results, but, if not, I commend them to him. One of the findings of the review in terms of machinery of government was that it would be more sensible to join upthat hideous phrasesome of the work that is done across Departments in respect of the early years, early development and health of young children. As a consequence, my noble Friend Baroness Ashton was asked to lead an inter-departmental unit dealing with all of those issues. She is the lead Ministershe is a Minister in both the Department for Education and Skills and the Department for Work and Pensionsbut, as she is in another place, she cannot answer debates in this place. Consequently, somebody else must answer in this place, and I am that person.
	The hon. Gentleman made two major points, and he illustrated, partly through their wonderful names, the diversity of the nurseries and pre-schools in his constituency.
	The hon. Gentleman's first point was about what he described as over-regulation in the pre-school sector. He quoted some of his constituents who work in that sector and who have complained about spending more time with paper than with children. We obviously take that concern seriously. It is not the aim of Government to bury teachers or pre-school staff in paperwork. That is not the main job that they seek to do or the main job that we want them to do. They have a legitimate concern that paperwork will take them away from their primary function of caring for and looking after the development and needs of young children, but it is not in the Government's interest to increase the amount of paperwork and restrict the teaching and child care that take place.
	We are sympathetic to such concerns. Although we cannot control every piece of paper that the staff might be expected to fill in, we have responsibility for some of it. However, the hon. Gentleman must bear in mind that the regulatory processes of registration and inspection operated by Ofsted require some form filling. The Government do their best to ensure that that is simplified and that the forms deal with what is necessary. We do not want their number to expand just for the sake of it.
	The hon. Gentleman referred to child profiles that were 16 pages long and that had to be filled in for every child. There is certainly no requirement for profiles to be of a particular length, but pre-schools must keep records on their children's progress. I hope that he does not think that such a requirement is unnecessarily bureaucratic. The profiles can be simple and straightforward, and 16 pages seem to be excessive. However, there is no requirement for the profiles to be of that length, so I hope that the example that he cited did not arise out of a central Government diktat that meant that the profiles had to be of a particular length and overly burdensome.
	The regulatory processes are there to ensure quality and safety, so there must be a proper balance between the amount of the paperwork required and its purposes. If we get the balance right, I hope that no one will complain about having to do some paperwork. It is not the Government's intention that excessive paperwork should drive people out of the business of looking after children or providing pre-school care.

Richard Bacon: No one would dispute the need for balance. However, does the Minister accept that, when proprietors have filled in all the paperwork, have been told that they have met all the requirements but still cannot get the go-ahead for their plans, there is something about the bureaucratic processes of Ofsted that must be seriously examined?

Maria Eagle: I shall say something about Ofsted. It has a role in regulation and in ensuring that children are safe and well looked after and that the premises are safe and suitable. It provides the quality checks that parents require before they decide to leave their children in particular places or under the care of particular organisations. Parents must be sure that the places where they leave their children are safe and have proper standards. Taxpayers' money is used to fund elements of early-years provision so it is right for the House to expect the money to be properly used and accounted for so that we obtain value for money and proper quality and care. That is why the regulations exist.
	As I have said, there must be a proper balance. Ofsted took over responsibility for child care registration and inspection from local authorities only last September. That has some advantages in the sense that pre-schools now have to work to only one set of standards. Before that, there were 150 sets of standards that varied from local authority to local authority and their interpretation of the requirements differed. We are bringing together the requirements into a national standard that should make it clearer and easier to meet them. The system is settling down but I say to the hon. Member for Witney and to those who take an interest in the subject that we want to ensure that it settles down properly. We certainly do not intend to impose more regulatory burdens, red tape and form filling than is absolutely necessary to meet the legitimate concerns of Government, parents and taxpayers.
	The hon. Gentleman said that it was a requirement that all four-year-olds should go to primary schools at a single point of entry. He also made it clear that some of the changes considered in Oxfordshire have been proposed by the LEA. That is therefore a matter for the LEA, not the Government. If we told each LEA what to do, he would no doubt raise that in a debate on how Whitehall is trying to micro-manage bits of his constituency.
	I am aware of the fact that the hon. Gentleman's LEA proposes to change admission arrangements for primary schools. He gave some of its reasons for that and he is rightly attending constituency meetings about it. The LEA proposes to move from a three-point entry of admission to a reception class to a single point of entry. It wants to do that for various reasons, some of which the hon. Gentleman mentioned. The Government do not have a preferred best way of doing that. We laid the schools admission code of practice before the House on, I think, 15 November. The hon. Gentleman will find it useful for discussions with his LEA because it sets out the Government's suggestions.
	It is for the admissions authority in the first instance to produce policies and it must consult. The consultation process in Oxfordshire has been going on for, I think, a couple of years. No one could argue that the authority is jumping to conclusions. There has been an extensive consultation, which is how it should be, and I understand that it will reach some conclusions in the new year.
	The Government are fully committed to parental choice in early-years education. We are not telling authorities like the LEA in the hon. Gentleman's area that it should have a single point of admission. That is a matter for the local area to decide on after consultation. If a single point of admission is accepted, I do not deny that some parents will feel under pressure to transfer their children from pre-schools to schools, as the hon. Gentleman said.
	The schools admission code of practice encourages admission authorities to allow parents to secure a place at a school of their choice and to defer entry. That should deal with some of the problems raised. Some authorities already do that. I am sure that Oxfordshire will consider all the issues before it comes to its conclusions. The policy suggested in the code of practice should alleviate some of the pressures on parents to get their children into a particular nursery at a particular time rather than leaving them in the pre-school.
	Our aim is to ensure that provision enables local parents to choose what is best for their child. What is good for one child might not be good for the child next door, and we are trying to ensure that local authorities provide diversity.

David Cameron: I am listening carefully. Does the hon. Lady accept the link between over-regulation, which is driving some of the small voluntary pre-schools to the wall, and the move to send more four-year-olds to primary schools, which are better able to cope with the regulatory burden? Perhaps she would like to visit one of those voluntary pre-schools with me to see the paperwork. My plea is that the Government do not crush those wonderful little gems because we will very much regret losing them.

Maria Eagle: The Government are certainly not interested in crushing gems. We are trying to promote and nurture diversity and choice for parents. I do not accept that the regulatory burden is driving schools to close. I hope that the hon. Gentleman accepts that the Government have an obligation to ensure safety and quality. These are, after all, places where parents leave their very young children; they need assurance about these issues and it is the Government's responsibility to make sure that they get it. Of course we are always willing to try to reduce the volume of paper. As I said, I think that there are misconceptions about what is required because the Ofsted regime is relatively new and is bedding in, and we all need to learn lessons about that.
	The hon. Gentleman referred to struggling pre-schools. I shall not deny that some pre-schools have struggled to exist, and some have closed, for a variety of reasons. We have, as the hon. Gentleman said, seen a steady shift in the balance of child care provision, away from playgroups and pre-schools towards the full day-care that parents want when they work full-time. We are encouraging pre-schools and playgroups to expand their services wherever possible and to provide child care over extended hours.
	We have allocated 6 million of capital funding to help with such conversion3 million this year and 3 million next year. The additional funding from the spending review doubled provision for child care and early-years education. Overall then, funding in this field is increasing. I hope that the hon. Gentleman will accept that although that does not always trickle down into every little school in every little village, we are doing our best to ensure that there is diversity and choice.
	We have no interest in trying to squeeze all pre-school and early-years provision into one nationally recognised and Government-preferred option, and we are not doing so. We are trying to encourage diversity and choice because that is what parents want and, in the end, that is what is best for our children.
	Question put and agreed to.
	Adjourned accordingly at nine minutes to Eleven o'clock.